'London patient’s' HIV remission brings hope to millions

Desiree Burns
March 5, 2019

He received other treatments as well, but by September 2017, he stopped taking anti-HIV drugs and has remained virus free for more than a year, the New York Times reported.

"By achieving remission in a second patient using a similar approach, we have shown that the Berlin patient was not an anomaly, and that it really was the treatment approaches that eliminated HIV in these two people", says virologist Ravindra Gupta from University College London.

The breakthrough has come via bone marrow transplants that were meant to cure cancer in the patients, not the HIV virus.

Some 37 million people worldwide are now infected with HIV and the AIDS pandemic has killed around 35 million people worldwide since it began in the 1980s. Until now, Brown is the only person thought to have been cured of infection with HIV, the virus that causes AIDS.

"At the moment, the only way to treat HIV is with medications that suppress the virus, which people need to take for their entire lives", said Gupta. "Everybody believed after the Berlin patient that you needed to almost die basically to cure HIV, but now maybe you don't".

The study describes an anonymous male patient in Britain who was diagnosed with HIV infection in 2003 and has been on antiretroviral therapy since 2012. Although the interventions that the two patients received could only be used on a tiny fraction of the 37 million HIV-infected people worldwide, their stories point to cure strategies that could be more widely applicable. The transplant destroyed the cancer without harmful side effects, while the transplanted immune cells, which are now resistant to H.I.V., seem to have fully replaced his vulnerable cells, according to the paper.

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Later that year, he was diagnosed with advanced Hodgkin's Lymphoma, a deadly cancer.

The transplants were from a donor with a mutation in a protein called CCR5, which rests on the surface of certain immune cells.

The Berlin patient - treated for leukemia - was given two transplants, and underwent total body irradiation, while the British patient received just one transplant and less intensive chemotherapy.

Brown remains uninfected as far as scientists can tell, and no HIV has been detected in the London patient's blood for 18 months, save for one blip of viral DNA that researchers studying the man suspect was a false signal.

Professor Gupta, now at Cambridge University, treated the patient in the United Kingdom capital when he was working at University College London. They also plan to present details in Seattle at the Conference on Retroviruses and Opportunistic Infections, which began Monday.

"This is a long time to be in remission off ART, so this is exciting", said Professor Sharon Lewin, Director of The Peter Doherty Institute for Infection and Immunity and Professor of Medicine at The University of Melbourne. "But we can try to tease out which part of the transplant might have made a difference here, and allowed this man to stop his anti-viral drugs".

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