Statement from Dr.

Timothy Henrich Regarding HIV Patients December 6, 2013

From: Timothy Henrich, MD, a physician-researcher in the Division of Infectious Diseases at Brigham and Womens Hospital in Boston The return of detectible levels of HIV in our patients is disappointing, but scientifically significant. We have demonstrated HIV can be reduced to undetectable levels by very sensitive research assays and the virus persists. Through this research we have discovered the HIV reservoir is deeper and more persistent than previously known and that our current standards of probing for HIV may not be sufficient to inform us if long-term HIV remission is possible if antiretroviral therapy is stopped. We have also learned that there may be an important long-lived HIV reservoir outside the blood compartment. Both patients have resumed therapy and are currently doing well. I am thankful for their commitment to research and our shared dedication in understanding this virus to benefit all HIV patients.

Background Information: The men had bone marrow transplants (one man in 2008, the other in 2010) as part of treatment for cancer. In both patients, HIV became undetectable approximately 8 months after transplant. At the time, the men remained on anti-retroviral therapy. Read the announcement. In the spring of 2013, the men ceased anti-retroviral therapy. Read the announcement. HIV became detectible in Patient #1 in August, 2013, 12 weeks after ceasing anti-retroviral therapy. HIV became detectible in Patient #2 in November, 2013, 32 weeks after ceasing anti-retroviral therapy. After the patients ceased anti-retroviral therapy, they were tested for HIV every 7-10 days. They both resumed anti-retroviral therapy after HIV was detected. The virus is suppressing as expected and they are both currently in good health. Brigham and Womens Hospital physician-researchers will continue to monitor the patients and continue to measure their HIV levels as part of a new study of the very early initiation of antiretroviral therapy after HIV rebound. The patients do not wish to be identified or interviewed.