Second man seems to be free of AIDS virus after transplant

Posted March 06, 2019

In 2016, he received a transplant of haematopoietic stem cells from a donor carrying a genetic mutation in the HIV receptor CCR5, which hinders the HIV virus from entering human cells. The London patient has not been off his antiretroviral drugs for 18 months, but has shown no signs of HIV despite regular testing.

In 2003, the male patient was diagnosed with HIV infection and developed an Aids defining cancer, advanced Hodgkin's Lymphoma, in 2012. The Guardina Newspaper in United Kingdom also reported that a London patient with HIV has become the second person ever to be free of the virus after a bone marrow transplant, raising hopes of a cure for Aids. He had leukemia and received a bone marrow transplant from someone with the CCR5 protein mutation. HIV is at its most unsafe when it is actively replicating, furiously producing as many copies of itself as possible so it can penetrate immune cells and spread infection.

For now, the patient has chosen to remain anonymous and he's being called the "London Patient".

Graham Cooke, from Imperial College London, said: "This second London patient, whose HIV has been controlled following bone marrow transplantation, is encouraging". Resistant to H.I.V. infection, these modified cells should eventually clear the body of the virus, according to The Times. "We speculate that CCR5 gene therapy strategies using stem cells could conceivably be a scalable approach to remission", they said. The study will also be presented at an HIV conference in Seattle.

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As of March 2019, some 37 million people globally were said to be living with the AIDS virus.

The case is proof of the concept that scientists will one day be able to end AIDS, the doctors said, but does not mean a cure for HIV has been found.

A London patient has become only the second person in history to be cured of HIV.

For this reason, he's often described as being the first patient "cured" of HIV, although technically that's incorrect, since remission and cures are not the same thing (as sometimes remissions are not complete, if the viral load stages a resurgence). The first patient - known as the Berlin patient - received a similar bone-marrow transplant in 2007 and has been HIV-free for more than a decade. But such transplants are unsafe, can not be used widely and have failed in other patients.

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Although a bone-marrow transplant cannot be a standard treatment for HIV, doctors can use what they learn in these special cases to try to develop new treatments that could be used by more people, Adalja said.

As with cancer, chemotherapy can be effective against HIV as it kills cells that are dividing.

He added: "There is no virus there that we can measure".

"I think this does change the game a little bit", Gupta opined to NYT of the new patient, who had less invasive treatment than Brown. "It shows the Berlin patient was not just a one-off, that this is a rational approach in limited circumstances", said Daniel Kuritzkes, chief of infectious diseases at Brigham and Women's Hospital, who was not involved in the study.

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