Essen/Berlin Patient

The Essen/Berlin patient is a man who goes by the pseudonym Christian Hahn (see the Resources entry for the book CURED: How the Berlin Patients Defeated HIV and Forever Changed Medical Science) with Non-Hodgkin’s lymphoma, CCR5-tropic HIV infection, and the HLA-B*5701 protective mutation (see the HLA-B*5701 and HLA-B*2701 Glossary entry). Because of the poor prognosis for his lymphoma, he underwent a CCR5 Δ32/Δ32 bone-marrow transplant. However, following the transplant, he was found to have either CXCR4-tropicTropic and Tropism or dual CCR5- plus CXCR4-tropic HIV infection and subsequently died from a recurrence of his lymphoma. It is not well understood why the CXCR4- or dual-tropic HIV infection was not detected; it may have been simply because there were very, very few such virions. Alternately, the detection failure may have been because the patient’s particular lymphoma is an AIDS-defining condition, and progress to AIDS and some biological changes that occur in parts of CD4+ T cells’ gp120 spikes are the clinical factors most likely to predispose a transition from CCR5 tropism to CXCR4 tropism.

Effects of Estrogen on Immune-System Cells

Cell TypeEffects
T cells
  • Increases expression of CCR5 and CCR1;
  • Lower doses enhance TH1 cell response;
  • Higher doses enhance TH2 cell response; and
  • Expands Treg cells
B cells
  • Increases survival;
  • Decreases apoptosis; and
  • Increases certain immunoglobulins
NK cells
  • Lower doses increase CD8+ T cell activity; and
  • Higher doses decrease CD8+ T cell activity
  • Increases certain immunoglobulins
Dendritic cells
  • Increases production of several cytokines; and
  • Promotes cell differentiation
NeutrophilsEnhances anti-inflammatory activity
Macrophages & Monocytes
  • Lower doses promote cell differentiation and stimulate cytokine production; and
  • Higher doses reduce expression of CD16 and decrease cytokine production
Table 1. Estrogen’s impact on immune system cells.
For explanation of terms see the notes below.