By Matthew Hodson - @Matthew_Hodson


The news that a London man had apparently been ‘cured’ of HIV caused a flurry of excitement. The London patient, who wishes to remain anonymous, had cancer and few remaining treatment options for it. He was given a stem cell transplant from a donor with a particular uncommon mutation that stops HIV infecting cells. Tests now suggest that his cancer is in remission and, despite no longer taking HIV treatment, his viral load has not rebounded. It appears he has been cured.

The treatment was close to that which resulted in the first case of ‘HIV cure’, often referred to as the Berlin Patient. In almost a decade between these two cases the same process has been attempted with other patients without achieving that same outcome.

Hold fire on the celebrations though. This treatment is brutal. It involves intense chemotherapy, pills so toxic they have to be handled with gloves and complete isolation to protect the body while the immune system is ‘switched off’. This is not a process anyone would choose. Standard HIV treatment is far less gruelling, less dangerous and less expensive, even if you have to keep taking it forever.

There are other, less traumatic and less expensive, cure options being explored. A treatment involving broadly neutralising antibodies (bNAbs) has led to viral suppression for up to six months, which suggests that this is an avenue worthy of further investigation. Another approach, tested on monkeys, has been to use gene-splicing to remove retroviral genes from cells – the molecular scissors approach. Both these, and other approaches, are promising but far from proven or practical yet.

Any cure progress is welcome but, after more than two decades of living with the virus, I don’t expect to benefit personally. I haven’t got the energy to start counting down the years as each new promising development is announced. I need something that is cheap, easy to administer and unlikely to kill you. And I’m going to need evidence of success in human trials before I’ll allow myself to hope.

If a cure is developed, who will get it? We have had effective treatment for HIV for almost 23 years now. HIV treatment has the power to stop people developing AIDS, it also has the power to prevent HIV being passed on during sex. Yet, despite this astonishing progress and potential impact, more than one-third of people living with HIV globally still do not have access to treatment. The idea that a cure will be rolled out to everyone with HIV in any short period, when we haven’t even succeeded in treating everyone after more than two decades, is naïve.

I’ve been living with HIV for more than 40% of my life. My worst fears about having HIV have been largely allayed. I’m confident that so long as I continue to have access to treatment I won’t get AIDS. That same treatment means I’m not a risk to my sexual partners, and that’s a huge relief. The all too frequent fear, ignorance and cruelty that people with HIV still face is bothersome but I’ve been open about my status for so long now that I’m able to bat most of it away. Taking a couple of pills a day is a relatively minor burden.

If there was a cheap, easy to administer cure then maybe there would be hope of major international programme. Experience tells me that all too often cost considerations take priority over saving lives. If the cure is only accessible to those in the West, are we okay to leave the rest of the world behind? Would there be the same commitment to manufacture life-saving treatment once a cure is available? What happens if the cure is not available to all?

I’m quite prepared now that I might never be cured. I’m okay about that. I’d rather die with HIV than accept a cure which isn’t available to all and which may hamper HIV treatment access for others.


Matthew Hodson is the Executive Director of NAM/aidsmap. Visit www.aidsmap.com.


Read all the articles from FS 171: