A little more than 30 years ago, when the scope of the HIV/Aids pandemic became public knowledge, an understandable mood of despair settled on the medical community and general public. The disease was considered deadly and seemingly immune to treatments available at the time, but today there is reason for optimism.
In mid 2010, a little girl was born to a woman somewhere in Mississippi in the US. The mother had no pre-natal care and, thus, did not know that she was infected with HIV. A routine test showed she was. Sadly, so was her newborn.
The doctors transferred the baby to University of Mississippi Medical Centre and put her on three antiviral drugs (AZT, 3TC, and Nevirapine) at higher-than-usual dosages, beginning only 30 hours after birth. That swift and strong remedy killed the virus before it could create “hideouts” or “niches” in the child’s immune system.
Months later, doctors announced that even though her blood showed traces of HIV, the virus was not able to replicate or invade other cells. Medics then declared the child “functionally cured”, meaning the virus was in long-term remission.
The Berlin Patient
That, however, was not the only “cure” announced. In 2007, Timothy Ray Brown, popularly known as the “Berlin Patient”, became the first man on record to have been cured of HIV, triggering a flurry of medical trials across the world as researchers believed the therapy could be replicated or modified to treat other patients. Brown’s story is arguably one of the most followed in the realm of HIV research.
Nearer home, a similar trial is being conducted by Dr Simon Barasa Situma of the Technical University of Kenya, formerly Kenya Polytechnic. Dr Barasa has modified the world’s first recorded HIV “cure” and says it has worked effectively on four of his patients and that another 18 currently under observation “are doing well”.
“Consecutive tests show they carry no virus, but we have to monitor them for at least six to 12 months to be sure they are free of HIV,” explained Dr Barasa, a practising pharmacist, during a presentation last week at TM’s Second World Virology and Microbiology Conference in New York.
“I have demonstrated the HIV cure in two people by stopping rapid multiplication of CD4 progenitor cells in the bone marrow, where the HIV virus hides (to avoid) elimination by the immune system and thus achieved the first complete cure without bone marrow transplantation,” Dr Barasa said.
His treatment, he says, is based on the world’s first known cure of HIV, that of Timothy Ray Brown, 47, who was diagnosed with HIV in 1995 and put on ARVs, but in 2006 developed leukaemia (blood cancer) and, for this reason, was given a bone marrow transplant with a rare gene mutation that provides natural resistance to HIV.
His doctor, Gero Hutter, said this resistance seemed to have been transferred to Brown, but Dr Barasa says this was not the case, arguing that the removal of Brown’s bone marrow did it.
“Removing the bone marrow, where the CD4 cells replicate, denied the virus the capacity to replicate and consequently the patient was free of HIV,” says Dr Barasa. Since the new bone marrow was resistant to the virus, the already existing bugs in circulation and from the secondary reservoirs — which include the brain, glands, intestines, and skin — could not create new hideouts, hence the ultimate eradication of the virus.
Bone marrow transplantation is a very expensive, specific, and dangerous procedure, which makes Brown’s treatment impossible to apply to the more than 30 million people with HIV. However, according to Dr Barasa, purging the virus from some specific locations where it seems to hide is the way out.
Medical doctors using antiretrovirals are able to bring down a patient’s viral load to undetectable levels, but once the patient stops the medication, the viral load goes up again.
“This means there is a reservoir in the body where the virus is hiding and where the ARVs are not able to reach. The hideout is in some parts of the bone marrow. Get rid of this reservoir and, theoretically, you are home and dry,” Dr Barasa says, adding that he has achieved this using a method that comprises the use of a cancer drug (methotraxate) in combination with other agents. Two patients who have undergone the therapy, Dr Barasa adds, have shown no signs of the virus for the past six months.
Methotrexate is used to treat cancer but is indicated to have very serious side effects and should not be used without advice from a competent physician.
“Although the drug is available in local pharmacies on prescription, it must never be used without clear instruction from your doctors,” says Dr Barasa.
The lecturer has since applied for a patent with the Kenya Industrial Property Institute for the treatment process, titled Cure for HIV/Aids Virus.
“Our methodology is simple, safe, acceptable, and cheap, although not yet scientifically validated,” says Dr Barasa in his case study. Even though we could not verify the claims, Dr Barasa says two patients, a man aged 29 and a woman aged 40, both of whom had previously been diagnosed with HIV and put on antiretroviral medication, “are now functionally cured”.
“We treated them with methotrexate, which works by suppressing rapid expansion of the specialised stem cells in the bone marrow, called hematopoietic cells,” he says.
The treatment consists of a combination of agents that are given in a methodology that is tailored to suit individual patients with continuous laboratory monitoring by Pathologist Lancet Kenya Limited, a fully-fledged reference laboratory situated in Nairobi’s Upper Hill area that boasts a wide test menu, including sophisticated molecular tests.
Within two weeks, he says, the patients showed tremendous improvement, healing of symptoms related to HIV/Aids and recorded undetectable viral loads in their blood after eight weeks for the man and 10 weeks for the woman.
“They have remained with undetectable levels of viral loads six months after the procedure,” says Dr Barasa who, on the road to this treatment together with his colleagues, regularly sought advice from both Mr Brown and his doctor through email exchanges.
In one such communication they wrote to the cured patient: “We are working diligently here in Kenya to see if we can achieve the same status as you did by interfering with the bone marrow, which is the critical reservoir for the virus.”
Dr Isaac Orina, a neuroscientist and chairman of the Department of Pharmaceutical Technology at Technical University of Kenya, says it is too early to celebrate victory “since the HIV/Aids war is far from over”.
“The disease is still a significant health threat in the world,” says Dr Orina, “but whether it’s going to be a complete cure for HIV or not, the fact remains that functional cure has a huge potential in eradicating the pandemic. A lot of research is, however, needed, and we are closely following Dr Barasa’s work. We hope the university will work with him once the preliminary findings are scientifically validated.”
Dr Orina says what Dr Barasa and other doctors around the world are doing is “very interesting” and can be an important step towards getting rid of the HIV virus.
“The only thing that we need is government support. Most scientists here lack funds to conduct research on such essential health issues,” he concludes.
As he waits for funds, Dr Barasa is holed up in his laboratory, shaking the tree of science.