'London Patient' Appears to Become the Second Person Ever Cured of AIDS

Faith Castro
March 6, 2019

A transplant of bone marrow stem cells from a donor with that specific mutation has seemingly cured the man, known only as the "London patient," of his HIV infection.

However, 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 problems cleared up without intervention, though, and the patient was left with immune cells that lacked the protein used by HIV. Rather than replace the patient's stem cells with just any match, physicians used ones with a special HIV-resistant mutation.

The new case, the "London patient", was diagnosed with HIV in 2003, and put on antiretrovirals in 2012. HIV-1 remission following CCR5Δ32/Δ32 haematopoietic stem cell transplantation. As of now, people who have been diagnosed with HIV have to take antiretroviral medication to suppress the virus for the rest of their lives. However, because HIV remained undetectable, he is still considered clinically cured of his infection, according to his doctors.

Most experts say it is inconceivable such treatments could be a way of curing all patients.

So could stem cell transplants lead to cures for some of our most vexing diseases?

That patient's disease was sent into permanent remission using treatment described as aggressive and toxic. 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.

Brown - the first and so far only person known to have been cured of HIV - received two stem cell transplants to treat leukaemia in 2006.

While some commentators are calling this a "cure" for HIV, the scientists who performed the experiment say it's too soon to say that. That transplant also appeared to clear his HIV infection.

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The research was funded by Wellcome, the Medical Research Council, the Foundation for AIDS Research, and National Institute for Health Research (NIHR) Biomedical Research Centres at University College London Hospitals, Oxford, Cambridge and Imperial.

The study is to be published Tuesday in the journal Nature.

Ravindra Gupta and his colleagues write, "it is premature to conclude that this patient has been cured", but they are hopeful that will prove to be the case.

Dr. Gupta from University College London has stated that the two rounds of successful treatment prove that the Berlin patient "was not an anomaly". This case may in time lead to the development of therapies that have less risk and a greater chance of successfully leading to HIV remission.

The Berlin patient's cure was one of magnificent serendipity.

Scientists are also examining immune modifying therapies. "It's been 10 years since the last success, and I was totally prepared for failure of the graft or return of the lymphoma", he says. "I do have hope".

"We've always wondered whether all that conditioning, a massive amount of destruction to his immune system, explained why Timothy was cured but no one else", AIDS expert Dr. Steven Deeks, who has worked with Brown medically, told NYT.

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