‘London patient’: second case ever of HIV remission

Second man seems to be free of AIDS virus after transplant

Nearly three years on, and more than 18 months after coming off antiretroviral drugs, highly sensitive tests show no signs of the man's previous HIV infection.

The breakthrough, which is detailed in a new paper in Nature, utilized the natural HIV-fighting power of a mutation called "CCR5 delta 32" which makes certain people resistant to the virus. While transplant is not the ideal option for HIV patients, it does offer hope in terms of where the researchers can take this.

Ravindra Gupta, an HIV biologist who helped treat the man, told Reuters that his patient is "in remission" but warned that it's "too early to say he's cured".

The London man was cured after he received a bone marrow transplant from an HIV-resistant donor, his doctors said.

Over a decade ago, a German doctor announced the first case of a patient who had been cleared of the virus.

"Common to both approaches is the presence of a modified gene in our immune system (CCR5) that is necessary for HIV infection".

After examining over and over the "London patient's" blood to look for H.I.V., the scientists could not find any circulating virus.

According to a United Kingdom study there a second HIV positive man who has been treated for AIDS. In 2016, his doctors suggested a bone marrow transplant to treat his cancer.

CCR5 is the most commonly used receptor by HIV-1.

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There may be real hope for sufferers with AIDS; after twelve years, a second person has apparently been cured of H.I.V., the virus that precedes AIDS. 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 CCR5 is a critical protein that must be present for HIV to be able to enter and infect cells. Essentially, the mutation prevents HIV from being able to get inside people's cells, so it can not cause infection.

The new case "shows the cure of Timothy Brown was not a fluke and can be recreated", Dr. Keith Jerome, Fred Hutchinson Cancer Research Center in Seattle, told the AP.

"I think so." He says he believes that some HIV still remains in the London patient's body, but that because his immune system is now impervious to the virus, the HIV is marooned - like a castaway on a remote island who can not swim.

The first known patient to be functionally cured of HIV is an American man, Timothy Brown, who also underwent similar treatment in Germany in 2007.

There have been other attempts to discontinue anti-retroviral therapy for HIV+ bone marrow transplant recipients, but in these cases the patient's virus has returned. But such transplants are unsafe, can not be used widely and have failed in other patients.

As with cancer, chemotherapy can be effective against HIV as it kills cells that are dividing. At one point during his treatment, the Berlin patient almost died and had to be placed in an induced coma.

"I think this does change the game a little bit", Gupta opined to NYT of the new patient, who had less invasive treatment than Brown.

Does this mean HIV has been cured?

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