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Milestone reached as HIV remission achieved in second patient

08 March 2019
Milestone reached as HIV remission achieved in second patient

Timothy Ray Brown, known as the "Berlin Patient" and the first person to have been cured of AIDS.

Both patients had received bone marrow transplants to treat blood cancers, receiving stem cells from donors with a rare genetic mutation that prevents HIV from taking hold.

Rare cases of remission, such as the London and Berlin patients "provide a lot of enthusiasm and motivation" for research teams and show that a cure can be achieved, he said, "but we still have a long way to go". He and his colleagues will continue to monitor the man's condition, as it is still too early to say he has been cured of HIV. Medical advances mean tests can detect HIV early, new drugs can control it, and there are ways to stop it spreading - but 37 million people still live with the virus.

Current antiretroviral treatments make living with the virus much more manageable to when doctors first began trying to treat HIV and Aids - unlike a few decades before, a diagnosis is no longer a death sentence.

Gupta's patient, a male resident of the United Kingdom who prefers to remain anonymous, was diagnosed with HIV infection in 2003 and began antiretroviral therapy in 2012. The man in question has been battling Hodgkin's lymphoma since 2012.

A man in London, England is now free of HIV/AIDS after stem cell transplant therapy. The Dusseldorf patient stopped antiretroviral therapy in November 2018, still has undetectable HIV and is undergoing continued monitoring. He is reported to have been in remission from HIV for the past 18 months.

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

People who have two mutated copies of the CCR5 allele are resistant to the HIV-1 virus strain that uses this receptor, as the virus can not enter host cells. The unexpected success has launched a new round of discussion about a potential cure for HIV. It's also not certain yet whether the London patient will remain HIV-free.

"I feel a sense of responsibility to help the doctors understand how it happened so they can develop the science", the "London patient" told The New York Times in an email.

"They used a reduced intense conditioning regimen but I think that had no influence on the outcome", he said. He believes translation of the approach into gene therapy could work - though it has not yet been proven - and if so, it could become an option for a large number of HIV patients. Anton Pozniak, president of the International AIDS Society, said, "Although it is not a viable large-scale strategy for a cure ... these new findings reaffirm our belief that there exists a proof of concept that HIV is curable". Patient is in HIV remission 18 months later.

Usually, HIV patients expect to stay on daily pills for life to suppress the virus.

"All HIV cure approaches in general are in their infancy", he said in a telephone interview. The X4 form of HIV, which uses a different protein, would not be tackled by treatment based on the delta 32 mutation.

"There are actually many strategies right now that are currently being pursued", Henrich said.

Like Brown, he required a bone-marrow transplant, in which blood cells are destroyed and replenished with those from a healthy donor.