The Second Person Ever To Be Cured Of HIV: "The London Patient"

Faith Castro
March 8, 2019

Both the first patient to be cured of H.I.V., Timothy Ray Brown, who is now 52 and was cured in 2007, and the new patient, whom scientists refer to as the "London patient", were afflicted with forms of cancer and were given bone-marrow transplants meant to treat their cancers, not the H.I.V virus, according to The New York Times. 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. Because both men were HIV-positive, doctors sought bone marrow from donors who have a genetic mutation that makes some people resistant to HIV. The first patient - known as the Berlin patient - received a similar bone-marrow transplant in 2007 and has been HIV-free for more than a decade.

A patient may have been cured of his HIV infection, according to a case study to be published Tuesday, marking the second time in the global epidemic's history of long-term remission from the viral disease. The team also found that his white blood cells now can not be infected with CCR5-dependent HIV strains, indicating the donor's cells had engrafted.

The therapy had an early success with Timothy Ray Brown, a US man treated in Germany who is 12 years post-transplant and still free of HIV. Now, tests show he has no sign of the HIV virus in his blood.

Nearly 1 million people die each year from HIV-related causes and the only current treatment available is for the affected to take antiretroviral drugs for their entire lives. After standard treatments failed, they gave the patient a stem-cell transplant - essentially killing off his old immune system and giving him a new one. He is only the second person documented to be in sustained remission without ARV, the researchers said.

Around 37 million people worldwide are believed to be living with HIV, which could potentially develop into the life-threatening acquired immunodeficiency syndrome (AIDS). This should encourage HIV patients needing bone marrow transplantation to consider a CCR5 negative donor if possible.

Unexpectedly, the stem cell treatment - from a donor with a mutation of the CCR5 gene, which is a co-receptor for the HIV-1 infection - ended up with Brown's HIV going into remission, where is has remained ever since.

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Researchers from University College London, Imperial College London, Cambridge and Oxford Universities were all involved in the case. "Everybody believed after the Berlin patient that you needed to almost die basically to cure HIV, but now maybe you don't". Brown had developed leukemia and needed two bone-marrow transplants.

The London patient, on the other hand, was able to undergo a far gentler regimen with similar results, though the broad therapeutic strokes were more or less equivalent.

Still, HIV has proven before to be a wily shapeshifter, and except for Brown, people who previously went in remission for various reasons for a year or so have always seen their virus start to replicate again.

"I never thought that there would be a cure during my lifetime", he said. The longer treatment is delayed, the greater the chance that HIV can also mutate to use CXCR4 and CCR5 to infect cells.

The team also found that the patient's white blood cells are resistant to CCR5-dependent HIV strains, which suggests the donated cells have become engrafted.

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