“My life is far from perfect, but this is my life.” Timothy Ray Brown died of leukemia at his home in California on September 29, local time. You may not have heard of his name, but his presence is a milestone in medical history: he is the world’s first HIV-cured person. His nickname may be louder – “Berlin Patient”.
Timsey Ray Brown.
The first “Berlin patient”
In fact, when the word “Berlin patient” first appeared at the end of the last century, it was not Timsi who was referring to it, but a rare German case. On 10 May 1996, a young German performed an unsafe sexual act. Three weeks later, he developed a series of infection symptoms, and a doctor in Berlin advised him to have an HIV test. On June 20, the patient was diagnosed with HIV.
Ten days later, the young German started cocktail therapy, combining several different anti-HIV drugs in an attempt to suppress the virus in a multi-pronged approach. Cocktail therapy has been a success. Soon, the level of the virus in his body plummeted.
But less than three weeks later, the patient was hospitalized with a testicular infection. Suddenly, he was not carrying medication for HIV infection. A few days later, the level of the virus in his body began to rebound, which was also in line with expectations. Fortunately, when the virus level remained low, he resumed medication and again pushed the virus down.
For the next few months, he continued to take the drug strictly until he had to stop four months later because of hepatitis. Surprisingly, after this suspension, the level of the virus in his body did not appear to have rebounded. After treatment for hepatitis, the patient “felt very healthy,” the New York Times reported. On a cold November night, he opened the window, breathed fresh air, and felt that his body was all right. Soon after, his medication began to become irregular: there were days when he was required to use cocktail medication, and there were days when he didn’t eat anything.
On Christmas Eve 1996, he told doctors that he had not been on time to take his medication. No matter how hard the doctor worked, he didn’t change his mind. Surprisingly, the level of the virus in his body did not rebound after he stopped taking the drug. Even the most advanced tests at the time could not find traces of the virus in his blood. Trace traces of the virus can only be detected in lymphatic tissue, which is the primary repository of the virus.
Scientists are divided on this phenomenon. Some say that timely treatment in the early stages of the disease promotes the production of specific AIDS-specific auxiliary T-cells, which allows patients to rely on their own immune system to suppress the virus after stopping the drug;
“When you’re HIV-positive, the virus stays in your body.” The Berlin patient said. He has not revealed his identity.
Second “Berlin Patient”
Timsey was born in Seattle on March 11, 1966, and raised by his single mother. Since high school, he has been open about his homosexuality. In 1995, one of his ex-boyfriends alerted Timsy to a test after being diagnosed with HIV positive. Similarly, Timsey is HIV-positive.
At the time, Timsi was going to college in Germany, majoring in German. After receiving the news of his diagnosis, he began treatment with Zidolfding and further used protease inhibitors the following year. Like many people living with HIV, cocktail therapy suppresses the virus in his body and allows him to live a normal life.
This lasted 10 years. The translator, who is usually healthy and rides 10 miles to and from work, is increasingly feeling tired. One day, he couldn’t even ride to a restaurant a mile away for lunch. At the hospital, 40-year-old Tim West was diagnosed with the second major disease of his life, acute myeloid leukemia (AML).
Timsey’s condition required immediate chemotherapy, with four rounds, each of which lasted a week, with a few weeks between them. According to his recollection, doctors inserted a hose around his neck that extended to his heart, and chemotherapy drugs entered his body. The first round of chemotherapy went well; the second round gave him fungal pneumonia, and antifelgial drugs allowed him to escape; and the third round of chemotherapy left him with a serious infection and doctors had to induce him into a coma for treatment.
Before the third round of chemotherapy, his attending doctor took a blood sample of him and sent it to the German Red Cross for matching. Many leukaemia patients couldn’t find a match, but Timsey had good luck – there were 267 matching types in the database, giving his attending physician a whole new space to operate.
In the population, some people are born with mutations in the CCR5 gene, which make them almost immune to HIV, making it impossible for these viruses to invade the body’s CD4 cells. Such populations are unusually small, accounting for only 1 per cent of people of Nordic descent. Of these 267 matching patterns, number 61 carries such a special mutation. After communication, the volunteer agreed to donate his stem cells. If he receives a stem cell transplant, Timsy is not only expected to cure leukemia, but also has a chance to cure his HIV infection “by the way.”
But Timsey rejected the offer. He had thought that the treatment for leukemia would begin with chemotherapy, which ended in chemotherapy, and that stem cell transplants would not be within his expectations. Despite chemotherapy-related problems, his leukemia appears to be under control and he can control his HIV infection by taking medication. “I don’t need to be an experimental mouse to risk my life and get a transplant that might kill me.” Timsey recalls. At the time, the mortality rate for stem cell transplants was 50%.
“Timsey Ray Brown”
By the end of 2006, Timsey’s leukaemia had returned. For him, receiving a stem cell transplant was his only option for survival. On 6 February 2007, he received his first transplant. After the operation, on the advice of his doctor, he stopped taking anti-HIV drugs. Three months later, doctors failed to find HIV in his blood, suggesting that the stem cell transplant had succeeded in suppressing HIV in his body.
But the good times didn’t last long, and Timsey’s leukaemia returned soon after. Doctors decided to use stem cells from the same donor and performed a second transplant on him in February 2008. The transplant brought a lot of risk, and Timsy was insanity, almost blind and paralysed. At one point, he even needed to learn how to walk at a rehabilitation center for people with severe brain damage. But in the end, he recovered after about six years. The researchers also found that even without the drug, the HIV in Timsy’s blood remained extremely low and could not be replicated.
At the 2008 International AIDS Conference, researchers reported on Timsey’s case. For a while, the headlines around the world were “AIDS is cured”.
As for Timsi’s cure, scientists believe there are several factors involved. First, he underwent chemotherapy and subsequent preparations for a stem cell transplant, completely destroying his own immune system. Second, the mutations that doctors have carefully selected for his stem cell donors could further deter HIV from attacking immune cells. Third, after receiving the transplant, “transplant anti-host disease” is a common phenomenon, which allows his new immune system to constantly attack the original residual immune cells, thereby removing the remaining HIV infection in the body.
To protect his privacy, Timsey’s identity was not initially made public, but was based on the location at the time of his diagnosis, known as the “Berlin Patient.” But since the report, his case has been explored and even raised questions about whether blood tests are rigorous or whether HIV is really not rebounding.
At the end of 2010, Timsey decided to make his name and image public. From “The BerlinEr,” he went back to Timsy Ray Brown. “I don’t want to be the only person in the world who has cured HIV. I want other HIV-positive patients to join me.” Timsey believes that disclosing his identity will allow him to better advocate for HIV research and treatment.
From patients in Berlin to patients in London.
“If my story is important, it’s just because it shows that HIV infection can be cured. If, medically, something can happen, it will continue to happen. Timsey said.
In 2019, Nature reported another cure for HIV infection. Like Timsy, an HIV-infected person develops severe blood cancer, and stem cell transplants with CCR5 mutations allow him to recover from lymphoma and no longer need anti-HIV medication. The case for healing is also known as the “London Patient”.
In March 2020, Patient London also released its identity. His name is Adam Castillejo, a former chef.
Adam’s appearance means that Timsy’s cure is no longer an isolated case and is of great importance. It also means that the CCR5 protein, which helps HIV-infected cells, could be an effective target for curing HIV infection. Although hematopoietic stem cell transplants are at great risk and cannot be a treatment option for conventional HIV-infected patients, other treatments developed based on CCR5 may have the potential to cure HIV infection.
And that’s exactly what Timsy wants to see. “I asked him what he really wanted to say to the public when he made his situation public,” says Tim Hoeffgen, Tim West’s partner. I never wanted to be the only one .’ “
In the end, a recurrence of a leukaemia unrelated to HIV left Timsy’s life at 54. The International AIDS Society published a commemorative article for this purpose, noting that he was a true fighter. Although his case with Adam is not a viable strategy for a large-scale cure for HIV infection, it provides important information for research related to HIV cure.
As many people say, this is a person who gives the world hope that HIV infection may be cured.
Timothy Ray Brown, First Patient Cured of H.I.V. , Dies at 54, Retrieved October 1, 2020, from https://www.nytimes.com/2020/09/30/health/timothy-ray-brown-first-patient-cured-of-hiv-dies-at-54.html.
The Berlin Patient, Retrieved October 1, 2020, from https://www.nytimes.com/1998/06/21/magazine/the-berlin-patient.html.
Timothy Ray Brown (2015), I am the Berlin patient: a personal reflection, AIDS Res Hum Retroviruses. DOI: 10.1089/AID.2014.0224.
HIV Resistant Mutation, Retrieved October 1, 2020, from https://www.nature.com/scitable/blog/viruses101/hiv_resistant_mutation/
How did the ‘Berlin patient’ rid himself of HIV? Retrieved October 1, 2020, from https://www.sciencemag.org/news/2014/09/how-did-berlin-patient-rid-himself-hiv.
IAS bids sad farewell to Timothy Ray Brown, “Berlin patient,” Retrieved October 1, 2020, from https://www.iasociety.org/The-latest/Blog/ArticleID/255/IAS-bids-sad-farewell-to-Timothy-Ray-Brown-the-%E2%80%9CBerlin-patient%E2%80%9D.