Although HIV is manageable, the cure for the disease remains a medical enigma. Every so often unique cases relating HIV being functionally cured crop up in the media. The most recent case comes from two men that appear to have been cured of HIV following a bone marrow transplant. Here we consider the implications of those findings.

The outcome of these cases was reported at the International Aids Society Conference in Kuala Lumpur. According to the medical team, two men who had lived with the virus for over 30 years received a bone marrow transplant as a part of their cancer treatment. In order for the treatment to be successful, the men kept taking their HIV medications.

As a consequence of the bone marrow transplant, the stem cells in each of the men were replaced. This of course is important; as the clinicians involved hypothesised that their recovery could have been a result of new stem cells creating immune cells to fight the disease. At the time of reporting, the men had been off their HIV treatment for 7 and 15 weeks respectively, and were still being monitored.

Although this report could be seen as a cause for optimism, the medical team that had worked on the cases urged for a cautious optimism and noted that it was too early to tell what the implications of the current findings would be in the long run. Similarly, it was noted that there was still a possibility that the virus remained dormant in other areas, such as the brain or the gastrointestinal region.

We feel inclined to agree with the medical team, as it is too early to tell where this finding could lead. From a clinical point of view, a bone marrow transplant for every patient with HIV is not feasible nor is it desirable, given that it is a costly, high risk treatment. Similarly, it is important to note that the men had a co-morbidity of lymphoma that required treatment and as such it is worth asking how much of that is applicable to individuals who “only” have HIV. As it is too early to tell whether the two men have been cured, it is also too early to see whether there are any side effects that will occur as a result of the bone marrow transplant.

What comes next is for the research community to consider the potential mechanisms that may have played a role in the recovery of these patients, and to study if it is possible to exploit these mechanisms to develop a safe and lasting treatment of HIV.