What the 'London patient' means for HIV/AIDS research

Faith Castro
March 6, 2019

A London man infected with HIV may be the second person in the world to beat the virus that causes AIDS, researchers reported Monday, a finding advancing the costly and challenging search for a cure.

The London Patient was given stem cells from a donor with genetic resistance to the disease. That's too soon to label the treatment - which used hematopoietic stem cells from a donor with an HIV-resistance gene - as a cure, researchers said Tuesday in a study in the journal Nature.

The latest case "shows the cure of Timothy Brown was not a fluke and can be recreated", said Dr. Keith Jerome of Fred Hutchinson Cancer Research Center in Seattle who had no role. His donor had a genetic mutation called CCR5 delta 2, which is resistant to HIV infection.

After the bone marrow transplant, the London patient remained on ARV for 16 months, at which point ARV treatment was stopped. But with the mutated CCR5, Brown's immune cells became molecular fortresses that HIV couldn't penetrate - which meant the transplant essentially cured him of his infection.

Doctors found a donor with a gene-mutation that is naturally resistant to the HIV virus, according to the findings.

Calling the London patient "cured" is tricky, Gupta said, because there is no standard definition for how long someone must remain free of virus and off treatment drugs.

Twelve years ago an individual was functionally cured of HIV through a stem cell transfusion.

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Dr. Gupta from University College London has stated that the two rounds of successful treatment prove that the Berlin patient "was not an anomaly". Many populations of blood and immune cells are replaced regularly.

Any story about an HIV cure is bound to stir excitement.

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.

Publicly, researchers have dubbed the treatment plan a "cure", though there's a major caveat: Bone marrow transplants are risky procedures with side effects that can last a lifetime.

He was diagnosed with HIV in 2003 and put on antiretroviral therapy since 2012. The CCR5 is a critical protein that must be present for HIV to be able to enter and infect cells.

The "London patient" told the Times, "I feel a sense of responsibility to help the doctors understand how it happened so they can develop the science", adding that when he was apprised he might be cured it felt "surreal" and "overwhelming". "Some of them are directly related to the Berlin patient and work with transplantation: for example, gene modification therapy".

Reports seen by Briefly.co.za today indicated that doctors conducted numerous tests on the said patient and they could not find a single trace of the HI virus three years after the bone marrow transplant procedure. "It shows the Berlin patient was not just a one-off, that this is a rational approach in limited circumstances", Daniel Kuritzkes, chief of infectious diseases at Brigham and Women's Hospital (who was not involved in the study), told the paper.

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