Doctors say second HIV patient is in ‘long-term remission’


An HIV-positive patient in London has become the second known adult in the world to be cleared of the virus after receiving a bone marrow transplant from an HIV-resistant donor, his doctors have announced.

The man began antiretroviral therapy for HIV in 2012 and that same year was diagnosed with advanced Hodgkin’s lymphoma, a blood cancer, and underwent the bone marrow transplant in 2016 in a bid to save his life.

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After receiving three years of the stem cell treatment from a donor with a rare genetic mutation – known as CCR5 delta 32 – that naturally resists the virus, he is showing no trace of infection despite stopping his antiretroviral medication 18 months ago, Reuters reported.

The “London patient” is being described as “functionally cured” and “in long-term remission” by doctors, but they caution it’s too early to determine whether he’s fully cured and it does not mean a HIV cure has been found.

The case study will be published this week in the journal Nature, and comes after a man known as “the Berlin patient” underwent a similar treatment for his leukaemia that cleared him of HIV in 2007. The man now lives in the United States and experts say he is still HIV-free.

Ravindra Gupta, a professor and HIV biologist who treated the London patient, told Reuters there was “no virus there that we can measure. We can’t detect anything.”

“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,” he said.

Scientists tried numerous times to replicate the “Berlin patient” case in other cancer patients with HIV, but the virus always returned or the patients died of cancer.

The Berlin patient suffered severe complications following his transplant, and the complex and risky bone-marrow transplantation procedure is not a realistic treatment option for HIV.

But the London case is being hailed as a milestone in HIV and AIDS treatment, providing proof of the concept that scientists could one day stop the virus completely.

Professor Gupta said more work needs to be done and his team plans to use the findings to examine potential new strategies for HIV treatment.

“We need to understand if we could knock out this [CCR5] receptor in people with HIV, which may be possible with gene therapy,” he said.

Dr. Sharon Lewin, director of the Peter Doherty Institute for Infection and Immunity and a professor of medicine at the University of Melbourne, was not involved in the new study but said the London patient’s long period in remission without medication was an exciting development.

“Coming 10 years after the successful report of the Berlin Patient, this new case confirms that bone marrow transplantation from a CCR5-negative donor can eliminate residual virus and stop any traces of virus from rebounding,” she told CNN.

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“Two factors are likely at play: the new bone marrow is resistant to HIV, and also, the new bone marrow is actively eliminating any HIV-infected cells.”

Modern medication prevents HIV transmission by reducing the viral load of those living with HIV to “undetectable” levels, meaning they can’t pass it on to others.

 

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