Second man seems to be free of AIDS virus after transplant

Desiree Burns
March 6, 2019

The man remained on antiretroviral therapy with undetectable viral load until November 2018.

There's only a single known case of the virus being eliminated entirely. After multiple trials, failures and repeat experiments, researchers have finally had success with the second case of medically-treated remission from HIV infection.

"HIV Is Cured In 2nd Patient, Doctors Report". "I think that finding a scalable cure that is safe and can be applied to a vast majority of individuals living with HIV is definitely attainable, but we have a lot more work to go".

Specialists said it is also not yet clear whether the CCR5 resistance is the only key or whether the graft-versus-host disease may have been just as important. Brown, now 52, had leukemia and underwent two bone marrow transplants, being placed in an induced coma following his treatment before eventually recovering.

Computer illustration of a human immunodeficiency virus (HIV) particle. Today people can live normal lives with HIV and, as best as we can tell, live to a full age. Hematopoietic stem cells give rise to other blood cells. That's considered high risk, as the elimination process involves high levels of radiation or toxic chemicals.

"If you are saying that bone marrow transplants are now going to be a viable way to cure large numbers of people with HIV in a scalable way, the answer to that is absolutely not", says Dr. Anthony Fauci, director of the National Institutes of Health's National Institute of Allergy and Infectious Diseases. They typically require knocking down the body's immune system to prevent it turning on the foreign cells. And that's exactly what happened in the earlier case. Like Brown, his donor had a double CCR5-delta-32 mutation.

This receptor was recently in the news after Chinese scientist He Jiankui claimed he'd edited the genes of embryos to include a protective version of CCR5.

He has been HIV-free, in remission, for 18 months, according to tests. Later in 2012, he came to know that he had Hodgkin's lymphoma, a rare kind of blood cancer.

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This was the second time a man was cured of HIV after receiving stem cells from a donor with a genetic mutation known to resist the killer virus.

"I think that one thing we've learned is finding a scalable, economically feasible cure, or HIV remission, is going to be hard", said Timothy Henrich, an infectious disease specialist at the University of California, San Francisco.

Unfortunately, stem cell transplants are not only expensive, but risky.

A bit over two months after the transplant, the patient showed signs that his new immune system was attacking his own cells. In Brown's case, he had leukaemia and was in need of bone-marrow transplants since his chemotherapy was failing him.

But a reservoir of cells carrying HIV can still remain in the body, in a resting state, for many years.

"There was no virus that we could measure". To begin with, some existing variants of HIV can bind to a protein that's closely related to the one mutated in the sources of successful transplant cells. Currently, there are powerful and effective drugs available to control HIV infection with few or no side-effects.

The researcher, who further explained that the method used is not appropriate for all patients, offered hope for new treatment strategies, including gene therapies.

A man known only as the "London patient" appeared to be cured of H.I.V. Other patients treated in a similar way since the Berlin patient have not seen similar results.

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