Doctors Announce They Have 'Cured' a Second Person of HIV Infection

Maricruz Casares
Marcha 8, 2019

The "London patient" case, cautiously reported in the journal Nature as still too "premature" to be declared a cure, comes a decade after Timothy Brown, known in medical circles as the "Berlin patient" was cured by a similar stem cell transplant, galvanizing the field of HIV research and sparking the search for a cure.

Now, for the second time, in the same conference, it has been announced that the second patient has been cured of HIV infection.

According to Reuters, experts say that it may not be possible to widely adopt the procedure given its complexity and the difficulty of finding donor matches who have the HIV-resistant genetic mutation. Attempts to treat the cancer with a variety of chemotherapies failed, at which point his doctors started considering stem cell transplants, but they were unable to obtain enough stem cells from the patient himself. They're also impractical to try to cure the millions already infected.

"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. So, pre-screening the HIV population would appear to be critical to identifying the patients that this can help. It's unclear why he waited that long. In 2007, he received a rare form of bone marrow transplant involving haematopoietic stem cells to treat his leukaemia. He took antiretroviral therapy drugs for HIV until September of 2017, doctors say.

This is the second time a person has been cleared of HIV following a bone marrow transplant from a donor with this genetic mutation. About 1 percent of people descended from northern Europeans have inherited the mutation from both parents and are immune to most HIV. The donor had this double copy of the mutation.

That was "an improbable event", said Gupta. "That's why this has not been observed more frequently". He then underwent a bone-marrow transplant in 2016 after receiving a diagnosis of advanced Hodgkin's lymphoma, initially having been treated with chemotherapy.

The patient agreed to stop taking HIV drugs to see if the virus would return.

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In the history of the HIV pandemic, only one patient had ever successfully shown the most common strain of the virus, HIV-1, could be put into remission.

That didn't happen with the London patient.

"It's not a cure yet, but 18 months is a fairly long time without a rebound", Kiem said.

"This is not a treatment appropriate for people with HIV who do not have cancer", the Treatment Action Group said in a statement.

"What we're talking about with a bone marrow transplant is getting rid of someone's immune system and giving them back someone else's immune system", says Dr. Rosenthal. He also received less aggressive conditioning chemotherapy (lomustine, cyclophosphamide, cytarabine and etoposide), alemtuzumab (Campath, a monoclonal antibody that targets CD52 on malignant B and T cells), and cyclosporine-A and methotrexate, immunosuppressive drugs used to prevent graft-versus-host disease (when transplanted immune cells attack the recipient's body). There are complications too.

"While we fully understand that stem cell transplantation is not a practical way of curing large numbers of people, we can learn a tremendous amount from these cases" said amfAR Chief Executive Officer Kevin Robert Frost.

The news about the London patient also encourages Paula Cannon at the University of Southern California in Los Angeles.

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