Published: Tue, March 05, 2019
Medicine | By Brett Sutton

Patient Cleared of HIV Virus Becomes World's Second AIDS Cure Hope

Patient Cleared of HIV Virus Becomes World's Second AIDS Cure Hope

A London man is believed to be the second person ever to be cured of the HIV virus after he received a bone-marrow transplant, his doctors reported Monday. The transplant destroyed the cancer without harmful side effects, while the transplanted immune cells, which are now resistant to H.I.V., seem to have fully replaced his vulnerable cells, according to the paper.

The investigators are to publish their report Tuesday in the journal Nature and to present some of the details at the Conference on Retroviruses and Opportunistic Infections in Seattle. For now, its use is restricted to those who need the transplant for other reasons, not for HIV alone, said Henrich, who was not involved in the new case study.

The news comes almost 12 years to the day after the first patient known to be cured, a feat that researchers have long tried, and failed, to duplicate.

The Berlin patient was actually an American (real name: Timothy Ray Brown) diagnosed with HIV while living in Germany. It's unclear why he waited that long.

With the right kind of donor, his doctors figured, the London patient might get a bonus beyond treating his cancer: a possible HIV cure.

Later, the doctors found that the transplant changed the London patient's immune system, giving him the donor's HIV resistance. In one example, Pablo Tebas, an infectious disease specialist at the University of Pennsylvania, and his co-workers remove white blood cells from HIV-infected people and then knock out their CCR5 genes with a genome editor called zinc finger nucleases, a precursor to the better known CRISPR.

He underwent a so-called hematopoietic 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.

Gupta, now at Cambridge University, treated the London patient when he was working at University College London. "That's why this has not been observed more frequently".

To test whether he was truly in HIV-1 remission, the London patient disrupted his usual antiretroviral therapy. When drugs are stopped, the virus roars back, usually in two to three weeks.

The news about the London patient also encourages Paula Cannon at the University of Southern California in Los Angeles.

In case after case, the virus came roaring back, often around nine months after the patients stopped taking antiretroviral drugs, or else the patients died of cancer.

To learn more about the factors that favor a cure, amfAR, the Foundation for AIDS Research, a New York City-based foundation, in 2014 began to fund a consortium of worldwide researchers who do transplants in HIV-infected people with blood cancers. "After 2 years, we'll be talking more about 'cure, '" Gupta says.

It may have been 12 years since the famous 'Berlin patient' made history by becoming the first person to sustain HIV-1 remission without receiving anti-retroviral (ARV) drugs, but the newly announced case of an anonymous male British patient demonstrates the first result was not unique.

"I think this is really quite significant. There are similarities with the Berlin Patient case, but there are also differences".

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