London HIV patient becomes second person to be cured of AIDS

A blood test being administered on an individual to check for HIV in Chile on Dec 11 2018

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. "I never thought that there would be a cure during my lifetime".

That news, displayed on a poster at the back of a conference room, initially gained little attention.

"By achieving remission in a second patient using a similar approach, we have shown that the Berlin patient was not an anomaly, and that it really was the treatment approaches that eliminated HIV in these two people", says virologist Ravindra Gupta from University College London.

Although the patient has been in remission for 18 months, the authors of the British study published Tuesday in the science journal Nature cautioned it was too early to say he had been cured. The failures left scientists wondering whether Brown's cure would remain a fluke.

Timothy Ray Brown, 52, formerly referred to as the "Berlin patient", also underwent a bone-marrow transplant to treat his Leukemia.

Reuters reports that the man, whose identity has not been revealed, has tested negative for the virus nearly three years after he received a bone marrow transplant from a donor with an HIV-resistant genetic mutation. 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.

Brown was given harsh immunosuppressive drugs of a kind that are no longer used, and suffered intense complications for months after the transplant. Almost one million people die every year from HIV-related causes. "And so we've always wondered whether all that conditioning, a massive amount of destruction to his immune system, explained why Timothy was cured but no one else".

In the new case, now dubbed the "London patient", the anonymous male also received a stem cell treatment from a donor with the same CCR5 gene mutation, this time while being treated for Hodgkin's lymphoma.

Gupta's patient, a male resident of the United Kingdom who prefers to remain anonymous, was diagnosed with HIV infection in 2003 and began antiretroviral therapy in 2012.

Dr. Timothy Henrich, an associate professor of medicine and physician scientist at University of California, San Francisco's Department of Medicine, also noted that the London patient's treatment "is not a scalable, safe or economically viable strategy to induce HIV remission".

But replacing immune cells with those that do not have the CCR5 receptor appears to be key in preventing HIV from rebounding after the treatment. In one example, Pablo Tebas, an infectious disease specialist at the University of Pennsylvania, and his co-workers remove white blood cells from HIV-infected people and then knock out their CCR5 genes with a genome editor called zinc finger nucleases, a precursor to the better known CRISPR. IciStem maintains a database of about 22,000 such donors.

A London man is believed to be the second person ever to be cured of the HIV virus after he received a bone-marrow transplant, his doctors reported Monday.



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