Second Patient Achieves Sustained HIV-1 Remission After Treatment Cessation

Second Patient Achieves Sustained HIV-1 Remission After Treatment Cessation

Second Patient Achieves Sustained HIV-1 Remission After Treatment Cessation

An HIV-positive positive patient in London has been cleared of the virus after getting a bone marrow transplant to treat lymphoma, raising hopes for possible cure through stem cell transplant.

And the remission was achieved with a less toxic regimen than Brown, the Berlin patient, received, the researchers said.

The researchers say it is too early to say the patient is "cured" of HIV. Essentially, the mutation prevents HIV from being able to get inside people's cells, so it can not cause infection. So, the cost benefit of the prognosis following a bone-marrow transplant versus that on HIV antiretroviral therapy needs serious consideration. Again, the procedure was meant to treat Hodgkin's lymphoma, not HIV/AIDS.

"Coming 10 years after the successful report of the Berlin patient, this new case confirms that bone marrow transplantation from a CCR5-negative donor can eliminate residual virus and stop any traces of virus from rebounding".

The most promising way to end HIV in the USA, experts say, is to manage infected patients' viral loads with drugs, and to prevent the disease from spreading to more people. Public health experts have a bullish plan to end HIV in the United States by 2030, but it does not involve expensive and unsafe bone-marrow transplants. "That completely suppresses the virus [making it] undetectable".

Brown sat in the front row, stood for a round of applause and shook hands with lead researcher Ravindra Gupta of University College London after Gupta presented details on the London patient.

It's also not a realistic treatment option for most HIV patients, who don't necessarily have cancer.

"They used a reduced intense conditioning regimen but I think that had no influence on the outcome", he said.

He later developed cancer and agreed to undergo a bone-marrow transplant for treatment. The scientists say the treatment strategy is not practical as a standard approach for the millions now living with the illness.

This receptor was recently in the news after Chinese scientist He Jiankui claimed he'd edited the genes of embryos to include a protective version of CCR5. He's also a cancer patient who got a stem-cell transplant.

The first was Berlin Patient, Timothy Brown, who has remained free of HIV and off ART since a similar bone marrow transplant 12 years ago.

When people have two copies (one inherited from each parent) of this mutation, it prevents blood cells from having a CCR5 receptor.

"If something has happened once in medical science, it can happen again", Brown told The New York Times.

Doctors in London say they have apparently eradicated HIV from a patient's body.

There are important limitations to applying the findings of the London patient to a HIV cure, said Anthony Kelleher, director of the Kirby Institute at the University of New South Wales in Sydney.

The patient remained on ARV for 16 months after the transplant, at which point the clinical team and the patient made a decision to interrupt ARV therapy to test if the patient was truly in HIV-1 remission. And we've already identified individuals with cells that can't be infected by HIV (they have a mutation that damages or eliminates a protein that HIV uses to attach to cells), who can act as a source of HIV-resistant cells.

"There are actually many strategies right now that are currently being pursued", Henrich said. "The treatment we used was different from that used on the Berlin Patient, because it did not involve radiotherapy".

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