Stem cell patient 'cured' of HIV

Desiree Burns
March 7, 2019

The second man, who is only being identified as the "London patient" received a transplant of stem cells from a donor who had the rare gene mutation CCR5.

While a second patient experiencing HIV viral remission with a slightly less toxic cancer treatment is certainly encouraging progress, an 18-month remission does not equal a cure. Since the Berlin patient was cured, stem cell therapy and BMT have failed for many HIV-infected people with blood cancer, with the virus rebounding in some cases, and patients succumbing to their leukaemia or lymphoma in others.

He underwent a so-called haematopoietic stem cell transplant in 2016 from a donor with two copies of a CCR5 gene variant, a combination carried by about one percent of the world population.

Lead researcher Ravindra Gupta of University College London explained that they hoped that this transplant would help the cancer as well as the HIV infection.

There was no evidence of infectious HIV in the gut and lymph nodes of the "Dusseldorf patient" three months after he stopped taking antiretroviral medication, said Annemarie Wensing of University Medical Center Utrecht at a Seattle medical conference. But that treatment would cover only those types of HIV that rely on the CCR5 surface protein to break into the immune cells. These medications are so effective that today a person living with HIV has nearly the same life expectancy of someone without HIV infection.

"The stem cell transplant primarily involves reprogramming the immune system to be HIV-resistant".

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Some who have lived with HIV for years said the fact that it can be managed obscures the health complications that can arise from both the virus and its medication. They had found that northern Europeans descendents possess a genetic make-up that make them immune to HIV infection. This week Brown celebrated 12 years free of HIV and was at CROI to hear about the "London patient".

"Bone marrow transplants are risky", Fauci concludes.

"I did not want to be the only person in the world cured of HIV", Brown wrote in a medical journal in 2015, explaining why he chose to reveal his identity.

"The new bone marrow is resistant to HIV, and also the new bone marrow is actively eliminating any HIV-infected cells through something called "graft versus host" disease," said Lewin, co-chair of the International AIDS Society's cure research advisory board and a researcher at Australia's Doherty Institute.

The British patient is the second case of someone's body resisting HIV. Their immune system appears to be successful in controlling the virus, even without drugs.

The London breakthrough offers hope for a potential cure using gene manipulation and antibody technology to develop next generation therapeutics for an infection on which at least half a trillion dollars (US $562.6 billion) have been spent worldwide between 2000 and 2015. To some that means a cure; however, as Dr Annemarie Wensing of the University Medical Centre Utrecht, who was quoted by The NYT, said, "We don't have any global agreement on what time without viral rebound is necessary to speak about cure".

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