From sci-fi to sci-fact: A few HIV studies are actually morphingpeople’s genes. Though small, the trials have an ambitious goal:getting immune systems to control HIV—eventually, the plan goes,without an HIV combo. The therapies change the genetic material in yourwhite blood cells—mature CD4 cells in some cases, stem cells inothers—so they can disable the virus. They’re still in early tests butare showing some promise. Meet two positive men—one a treatmentveteran, the other with no med resistance—playing guinea pig indifferent studies (find these and others at www.clinicaltrials.gov).

The Longtimer
Timothy Spaulding, 47
Retired government worker
Lexington, KY
Diagnosed 1991

The History
Ichanged meds frequently due to side effects. I also had adherenceproblems due to job demands—so now I’m resistant to a slew of meds. By2004, my options were few. Since then, I’d been doing OK on Fuzeon withViread and Combivir, but my numbers started sliding again earlier thisyear. So my doctor found a gene therapy trial, and I became Patient No.8.

The Theory
A gene inserted in my CD4s binds with HIV’s genetic material, preventing the virus from reproducing.

The Procedure
MyCD4s were harvested—a five-hour process. They extract whole blood outof one arm. A machine removes the white blood cells. The rest isinjected back into the other arm. Then the CD4s are mixed with VRX496,a distorted version of HIV. A few weeks later, the mixture is drippedinto my arm—it takes about 15 minutes. I’ve had three infusions so far.I should get eight over 16 weeks. I stay on my combo.

The Results
Theday after each procedure, I feel fatigued, but then I snap back. Afterthe third infusion, my viral load was too high (and CD4s low) to getthe fourth. Recently it fell again. I got No. 4—and it seems I’m backon track.

The Outlook
Ihave hope. Every time I’ve hit bottom in my life with HIV, somethinghas come along to help. The worst case: This buys me some more years,and by then I hope we’ll have a whole new class of meds—entryinhibitors—available. Best case—the researchers say they will monitorme for 15 years. I’d like that.


The Newcomer
Michael Delane, 41
Credentials manager
San Francisco
Diagnosed 2002

The History
Atdiagnosis, my viral load was in the millions, CD4s at 924. I felt sick,so I started meds. I was 100% adherent and got my viral loadundetectable, but my CD4s kept falling. My doctor called my HIVaggressive. I want to be aggressive, too, so I signed up for a two-yeargene therapy study to obliterate HIV—right up my alley.

The Theory
My stem cells are genetically altered so they mature into CD4 cells that can resist HIV.

The Procedure
Mystem cells were harvested—slow but not painful—and genetically alteredto produce an enzyme (ribozyme) that attacks HIV at five points,shredding it. Then the altered stem cells were infused back into mybloodstream. I stayed on my meds until the new stem cells matured intoCD4s ready to stop HIV from infecting them
(it took 40 weeks). Then I stopped all meds.

The Results
Thatwas eight months ago. Today, without taking an HIV regimen, I’m holdingsteady with an undetectable viral load and CD4s ranging from the upper300s to mid-400s.

The Outlook
Iwould do it again in a heartbeat. I don’t know if I’ll stayundetectable forever, but these eight months have been great—no meds,no side effects. I feel like I have control over this stupid monkeyvirus. I have every confidence that science will soon prevail over HIV.I’m happy to be a part of that.