Second man seems to be free of AIDS virus after transplant
05 March, 2019, 12:27 | Author: Denise Dawson
So far, its scientists are tracking 38 HIV-infected people who have received bone-marrow transplants, including six from donors without the mutation. Beforehand, each had been treated with toxic chemicals in a "conditioning" regimen meant to kill off their existing cancerous bone marrow cells.
He still doesn't take antiretroviral treatment, the treatment that most people with HIV take, and yet he remains essentially cured. HIV uses the protein to enter those cells but can not latch on to the mutated version.
Researchers from University College London, Imperial College London, Cambridge and Oxford Universities were all involved in the case. In interviews, most experts are calling it a cure, with the caveat that it is hard to know how to define the word when there are only two known instances. Three years after receiving stem cells from the donor with a rare genetic mutation resistant to HIV, the latest tests show no sign of the patient's previous HIV infection.
Later, the doctors found that the transplant changed the London patient's immune system, giving him the donor's HIV resistance.
The London Patient has chosen to remain anonymous. The man suffered from post-procedure complications whereby the donor's immune cells attacked his own. The London patient is one of 40 in the study. He was diagnosed with HIV in 2003. "Durable engraftment" of the CCR5 mutants is key to a cure, he concludes.
The news comes almost 12 years to the day after the first patient known to be cured, a feat that researchers have long tried, and failed, to duplicate.
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The International AIDS Society said in a statement Tuesday that results from the second patient "reaffirm our belief that there exists a proof of concept that HIV is curable". "That could be a fantastic way forward", Johnston says.
The man is being called "the London patient", in part because his case is similar to the first known case of a functional cure of HIV-in an American man, Timothy Brown, who became known as the Berlin patient when he underwent similar treatment in Germany in 2007 which also cleared his HIV.
CCR5 is the most commonly used receptor by HIV-1 but people who have two mutated copies of the CCR5 allele are resistant to the virus strain that uses this receptor. The researchers expand the modified cells and then reinfuse them into their patients with the hope that they will engraft and populate the blood.
The "London patient" had Hodgkin's Lymphoma and also received the same CCR5 mutation in May 2016. he has stopped taking ART drugs since 2017 and is HIV free. "I never thought that there would be a cure during my lifetime".
Effectively, some scientists believe that the "London patient" has been cured of the viral infection, which affects close to 37 million people worldwide. "I did a little happy dance when I read the paper", she says.
"The cost benefit of the prognosis following a bone marrow transplant versus that on HIV antiretroviral therapy needs serious consideration", says Professor Anthony Kelleher, Director of the Kirby Institute at UNSW Sydney.
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