Second man seems to be free of HIV after stem cell transplant

09 March, 2019, 01:58 | Author: Earnest Huff
  • Illustration – Pixabay | DarkoStojanovic

Share on PinterestScientists are hopeful that this new case could be a breakthrough for HIV treatment.

Prof Gupta's case was in an HIV-positive man with advanced Hodgkin's lymphoma who received a transplant of haematopoietic stem cells from a donor with two copies of the so-called CCR5 gene mutation - the same one allegedly edited by Chinese researcher He Jiankui that led to the birth of the world's first gene-edited babies previous year.

An HIV-positive man in Britain has become the second known adult worldwide to be cleared of the AIDS virus.

But the patient is in remission and is being monitored closely. "But is particularly hard because the virus integrates into the white blood cells of its host".

Before the London case, researchers had spent 12 years trying to replicate the effort that cured the "Berlin patient", later identified as Timothy Brown.

Professor Ravindra Gupta of University College London presented the case on Tuesday, but after a premature embargo break the day before, 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".

Also, while the London patient's cancer treatment was less intense, with just chemotherapy and the stem cell transplant, it was still toxic and is not a course of treatment that otherwise healthy people living with HIV infection should embark upon.

With the right kind of donor, his doctors figured, the London patient might get a bonus beyond treating his cancer: a possible HIV cure. Both men received stem cells from donors with an uncommon gene mutation known as CCR5-delta-32 that makes T cells resistant to most HIV.

After undergoing chemotherapy, he underwent a stem cell transplant in 2016 and also continued with anti-retroviral drugs for 16 months.

A coloured transmission electron micrograph of the HIV virus (green) attaching to a white blood cell (orange).

Timothy Ray Brown known as the “Berlin Patient” and the first person to have been cured of AIDS
Timothy Ray Brown known as the “Berlin Patient” and the first person to have been cured of AIDS

"So, the cost-benefit of the prognosis following a bone-marrow transplant versus that on HIV antiretroviral therapy needs serious consideration", UNSW's Kirby Institute director Professor Anthony Kelleher said.

Even so, the bone-marrow transplant that appears to have eliminated the virus is too risky, complicated and expensive to serve as a widespread cure. HIV expert Sharon Lewin said two factors were probably at play in his success story: the genetic resistance and a transplant side-effect that attacks immune cells.

Bone marrow transplants are no easy feat. One individual has shown no signs of H.I.V. for several months post-treatment, but it remains too early to tell whether he, like the London patient, is in long-term remission.

On top of that, there's the need to find a genetically matching donor - which is rare - along with the risk that the transplanted cells will not grow properly and the procedure could fail entirely, adds McGowan.

This is a hard treatment that carries a high risk of infection and other complications, such as graft-versus-host disease, blood clots and liver disease.

Close to 37 million people are living with HIV worldwide and almost one million people die every year from HIV-related causes.

As of now, the only way to effectively treat HIV is via antiretroviral drugs that suppress the virus. "People lead completely normal lives".

Those with the virus must take the drugs their entire life. Researchers extensively tested his blood, gut, brain and other tissues, finding no evidence of replication-competent HIV anywhere in his body.

"[The case] creates a huge amount of momentum around both the idea of ending the epidemic and around eventually finding a cure", Warren said.

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