Gero Hütter

Gero Hütter born 18.12.1968)[1] is a German hematologist. Huetter and his medical team transplanted bone marrow deficient in a key HIV receptor to a leukemia patient who was also infected with human immunodeficiency virus HIV). Subsequently, the patient's circulating HIV dropped to undetectable levels. The case was widely reported in the media,[2][3][4][5][6][7][8]and Hütter was named a "Berliner of the year" for 2008 by the Berliner Morgenpost, a Berlin newspaper.[9]

In 2009, Hütter, Eckhard Thiel and others from the Charité Hospital in Berlin, Germany, published a report on the case in the New England Journal of Medicine.[10] Their patient, a US citizen living in Berlin,[11] had both acute myelogenous leukemia AML) and HIV. The physicians found a bone marrow donor with a CCR5-Δ32 mutation in both genomic copies of a gene encoding a cell-surface chemokine receptor called CCR5. Because "almost all strains of HIV" use the CCR5 receptor to enter a host cell, the mutation confers resistance to HIV infection.[2][3] The patient himself was heterozygous for CCR5-Δ32. Following the transplant procedure, the patient's CD4+ T-cells circulating in the blood were homozygous for CCR5-Δ32. The macrophages in his bowel, which continued to express wildtype CCR5 (because they hadn't been replaced yet from bone marrow precursors), also had no detectable virus. After 600 days without antiretroviral drug treatment, the patient's blood, bone marrow and bowel HIV levels were below the limit of detection; the virus may be present in other tissues.

The mortality risk associated with bone marrow transplants is thought to contraindicate the use of this experimental treatment for HIV-positive individuals without leukemia or lymphoma.[2] Some researchers such as Edward Berger believe that resistance to CCR5 inhibition may emerge if CXCR4 strains of HIV emerge (these use CXCR4 rather than CCR5 as a coreceptor, from which they become independent).[12] Before the treatment though the patient had low levels of the CXCR4 virus but after the treatment this type of HIV could not be detected either which Hütter called "very surprising".[13] People without CCR5 can be more sensitive to some infections such as West Nile virus.[14]

Jay Levy, one of the first researchers to isolate and describe HIV in the early 1980s, wrote an editorial accompanying Huetter's publication in the New England Journal of Medicine.[15]Noting the reduction in detectable HIV in the patient's blood and the return of the patient's circulating CD4+ T-cell population to normal levels, with all of the cells expressing the resistant variant of CCR5, Levy cautions that calling this treatment a cure would be premature.[15] This is because HIV is known to hide in latent form in a variety of organs not easily sampled, including the heart and brain. The high risks of a bone marrow transplant also make this treatment risky since many bone marrow patients die.[15] And the CXCR4 virus that was detectable in the blood of the patient before the treatment "could eventually emerge".[15] Levy does believe though that this case "could pave the way for innovative approaches that provide long-lasting viral control with limited toxicities for persons with HIV infection".[15]

As of June 4, 2010, Dr. Huetter's patient was in very good health and had been HIV- and cancer-free (combined) for two years.[16]

Dr. Huetter received an award on June 3, 2010 from the AIDS Policy Project, a national advocacy group focused on an AIDS cure, and San Francisco Supervisor Ross Mirkarimi on behalf of the people of San Francisco.[17]

The text read:

"Dr. Gero Hütter: In recognition of your historic achievement of being the first doctor to functionally cure AIDS/HIV through an innovative procedure that entails a remarkable example of the use of stem cell transplants. We join you with hope that your achievement will globally inspire researchers to explore new techniques and technologies for an AIDS cure. On behalf of the people of San Francisco, the AIDS Policy Project, and all those engaged in the combat against the HIV disease, the City and County of San Francisco extends its highest commendation!" —Supervisor Ross Mirkaraimi, Member, San Francisco Board of Supervisors, June 3, 2010[16]