A second patient 'cured' of HIV. But consider what it took

Randy Kelley
March 9, 2019

For a second time, a man identified only as the "London patient" was reported to be cured of HIV-12 years after Timothy Ray Brown, also known as "Berlin patient", became the first known man to be cleared of HIV, the virus that causes AIDS.

Both the Düsseldorf and London patients received bone marrow transplants from people who had a rare genetic mutation which makes them resistant to HIV. "We can't detect anything".

Timothy Ray Brown, the Berlin Patient, had been living with HIV and routinely using antiretroviral therapy when he was diagnosed with a different disease, acute myeloid leukemia.

The study's lead author Dr. Ravindra Gupta, a professor at University College London and HIV biologist who helped treat the patient, said that there is no sign of virus but that it's technically too soon to say he's been fully cured. This is incredibly challenging for individuals in third world countries, the research team said.

Nearly 1 million people die annually from HIV-related causes.

A new drug-resistant form of HIV is also a growing concern.

News of possible cure is welcome considering the high rate of new HIV infections globally.

Sharon Lewin, director of the Peter Doherty Institute for Infection and Immunity in Melbourne and a leading expert on HIV/AIDS, told AFP it was likely one of two things had happened.

"We can try to tease out which part of the transplant might have made a difference here, and allowed this man to stop his anti-viral drugs".

"Finding a way to eliminate the virus entirely is an urgent global priority, but is particularly hard because the virus integrates into the white blood cells of its host". 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 worldwide agreement on what time without viral rebound is necessary to speak about cure". Then the patient receives a transplant of new stem cells from either themselves or a donor. "They would ideally try to take these mutated proteins, CCR5s, and inject them into people with HIV with the hopes that once they have this mutated CCR5 their HIV won't be able to attach to the immune cells anymore".

CCR5 is the most commonly used receptor by HIV-1.

A second person has been cleared of the HIV virus over 10 years after the first person to show long-term remission for the disease, CNN is reporting. Tests show that his CD4 T cells now lack the CCR5 receptors most types of HIV use to enter these cells. The man remained on antiretroviral therapy with undetectable viral load until November 2018.

He added that both the Berlin and London patients had this complication, which could have played a role in the loss of HIV-infected cells. "I can't tell you when we'll have a cure that can be useful for everyone but I can tell you were laser-focused on that goal".

The researchers caution that the approach is not appropriate as a standard HIV treatment due to the toxicity of chemotherapy, but it offers hope for new treatment strategies that might eliminate HIV altogether.

The research team for the London patient will present their findings at the annual Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle, Washington.

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