'London patient’s' HIV remission brings hope to millions

Faith Castro
March 7, 2019

The London-based patient becomes the second individual ever to be seemingly cured of HIV over a decade after the first: Timothy Ray Brown, AKA the "Berlin patient," who nearly died after his treatment, according to The New York Times.

Nearly three years after receiving bone marrow stem cells from a donor with a rare genetic mutation that resists HIV infection - and more than 18 months after coming off antiretroviral drugs - highly sensitive tests still show no trace of the man's previous HIV infection. It was a similar approach to that used on Timothy Brown, also known as the "Berlin patient", who remains HIV-free today after treatment in Germany in 2007.

The second person, dubbed "The London Patient", was treated by specialists at the University College London and Imperial College in 2016 and has shown no sign of the virus since. However, citing the use of total body radiotherapy in the first individual, but not in the management of the current patient, researchers highlighted the importance of future strategies for HIV remission to be based on preventing CCR5 expression. "We can't detect anything", says Ravindra Gupta, an HIV biologist who co-led the intervention.

"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", Gupta explained.

According to Professor Gupta, the London patient was HIV-positive since 2003, before he was diagnosed with blood cancer Hodgkin's Lymphoma in 2012.

AIDS researchers have known about the this CCR5 mutation for years and have tried to think of ways to exploit it as a treatment for HIV.

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As with cancer, chemotherapy can be effective against HIV as it kills cells that are dividing.

The transplant was relatively uncomplicated, but with some side effects including mild graft-versus-host disease, a complication of transplants wherein the donor immune cells attack the recipient's immune cells.

The patient asked to remain anonymous and is referred to as the "London patient". "H.I.V. uses the protein to enter those cells but can not latch on to the mutated version".

But it in the past 18 months he was taken off the extra drugs and regular testing confirmed his viral load is now undetectable. Notable differences were that the Berlin Patient was given two transplants and underwent total body irradiation, while the United Kingdom patient received just one transplant and less intensive chemotherapy.

Scientists who have studied the London patient are expected to publish a report Tuesday in the journal Nature. The London patient was given stem cells from a donor with the same mutation in CCR5 the Berlin patient received as well as immune-suppressing drugs. But doctors cautioned against calling the patient's results a cure for HIV, the virus that causes AIDS.

Gupta, now at Cambridge University, treated the London patient when he was working at University College London. They also plan to present details in Seattle at the Conference on Retroviruses and Opportunistic Infections, which began Monday.

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