The world now has a second person who has recovered from HIV

Pearl Mccarthy
March 7, 2019

Both cases bear similarities to that of the first person to be functionally cured of HIV after a stem cell transplant back in 2007, a man called Timothy Ray Brown and also known as the "Berlin patient". Dr Timothy Henrich, now at the University of California at San Francisco, and colleagues attempted to reproduce Brown's cure in two cancer patients in Boston, but in those cases the donors had normal or "wild-type" stem cells that remained susceptible to HIV, they received less intensive chemotherapy and they stayed on antiretroviral therapy. This gene codes for a receptor which sits on the surface of white blood cells involved in the body's immune response.

The International AIDS Society (IAS) has welcomed the announcement that a United Kingdom patient's HIV has become "undetectable" following a stem cell transplant.

The "London Patient" is only the second person known to have shaken off the HIV virus during a 40-year AIDS epidemic that has infected 70 million people and killed half of them.

Before yesterday some researchers had posited a third theory: That it was the intense combination of radiation and chemotherapy ahead of the stem-cell transplant that floored the virus. Although it is not a viable large-scale strategy for a cure, it does represent a critical moment in the search for an HIV cure. The London Patient has been HIV-free for 18 months since he stopped taking drugs.

Researchers have made several attempts to manipulate the immune system with interventions that target HIV and HIV-infected cells or that change the behaviour of immune cells to better address the infection. These medications are so effective that today a person living with HIV has nearly the same life expectancy of someone without HIV infection. Normally, HIV sufferers count on to remain on everyday drugs for all times to suppress the virus.

But replacing immune cells with those that do not have the CCR5 receptor appears to be key in preventing HIV from rebounding after the treatment.

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There are also a number of other HIV-positive patients who have had bone marrow transplants, including two patients who haven't yet come off their antiviral medications.

But such transplants are complex, expensive and highly risky to the patients, who would run a risk of dying in the process.

Speaking about the study, lead author Ravindra Gupta said, "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".

The research team for the London patient will present their findings at the annual Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle, Washington. The transplant modified the London affected person's immune system, giving him the donor's mutation and HIV resistance.

The anonymous "London patient" has been free of HIV for longer than the Dusseldorf case. However, this new case adds to the evidence that using gene therapy to delete CCR5 receptors from T cells may be a feasible approach.

"Although this breakthrough is complicated and much more work is needed, it gives us great hope for the future that we could potentially end AIDS with science, through a vaccine or a cure", Sidibé said.

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