Second Man Is HIV-Free After Stem Cell Transplant

06 March, 2019, 15:37 | Author: Denise Dawson
  • The man's doctors found a donor with a gene mutation that confers natural resistance to the HIV virus

Ravindra Gupta, now at the University of Cambridge, will present the case on Tuesday, but after a premature embargo break many media outlets reported the findings in advance, with some suggesting that the case represents a second HIV cure, similar to that of Timothy Ray Brown, known as the "Berlin patient". 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.

According to experts, the London Patient was stopped from taking antiretroviral drugs 19 months ago, with "no viral rebound".

To learn more about the factors that favor a cure, amfAR, the Foundation for AIDS Research, a New York City-based foundation, in 2014 began to fund a consortium of global researchers who do transplants in HIV-infected people with blood cancers.

Back in 2009, doctors published a report in the New England Journal of Medicine detailing the case of the "Berlin patient" - an HIV-positive man who'd received a stem cell transplant to treat his leukemia.

The identification of the HIV virus ultimately led to the development of therapies that specifically target the virus' ability to make new copies of itself.

Although a bone-marrow transplant cannot be a standard treatment for HIV, doctors can use what they learn in these special cases to try to develop new treatments that could be used by more people, Adalja said.

Scientists are looking at finding a way to inject a patient with modified immune cells that can resist the HIV virus.

For the London patient, Gupta and his team also found a donor who had these mutations in CCR5.

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The transplant, in other words, changed the key on the lock, and the virus could no longer get in. In 2007, he received a rare form of bone marrow transplant involving haematopoietic stem cells to treat his leukaemia.

Dr Gupta has two teams under him working for the cure of HIV in London and in South Africa, at the Africa Health Research Institute. So, pre-screening the HIV population would appear to be critical to identifying the patients that this can help. He and his colleagues will continue to monitor the man's condition, as it is still too early to say that he has been cured of HIV.

Does this mean HIV has been cured?

They caution, however, that it's too soon to declare the patient cured.

Experts universally hailed the case, even as they cautioned that the procedure that resulted in the likely cure - a bone marrow transplant to treat blood cancer - is too risky and costly to be applied as a general treatment for HIV, which can today easily be managed, though not cured, with pills.

This is the second time a person has been cleared of HIV following a bone marrow transplant from a donor with this genetic mutation.

While there isn't a hundred percent guarantee, the London patient has been off his medication for a year without any sign of the virus making a comeback.

This is the second known case of HIV going into long term remission. The new patient had none of this HIV variant, which probably contributed to the success of this treatment. He underwent intensive conditioning chemotherapy and whole-body radiation to kill off his cancerous immune cells, allowing the donor stem cells to rebuild a new HIV-resistant immune system.



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