'London Patient' Appears to Become the Second Person Ever Cured of AIDS

'London Patient' Appears to Become the Second Person Ever Cured of AIDS

'London Patient' Appears to Become the Second Person Ever Cured of AIDS

The man, who has been dubbed the "London patient", is the second person to receive the treatment. "As long as Timothy Brown was the only [one], we'd have always wondered if there [was] something unique about it"'.

Both milestones resulted from bone-marrow transplants given to infected patients.

Some 37 million people worldwide are now infected with HIV and the AIDS pandemic has killed around 35 million people worldwide since it began in the 1980s.

Virologist Ravindra Gupta at University College London, who is scheduled to describe the London patient's case tomorrow at the Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle, Washington, and online in Nature, resists using the term "cured" for the man, who remains anonymous.

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Doctors said a London man with HIV has become the second known adult in the world to be apparently cleared of the infection since the global epidemic began decades ago, giving hope for a potential cure for AIDS.

A new drug-resistant form of HIV is also a growing concern.

Brown remains uninfected as far as scientists can tell, and no HIV has been detected in the London patient's blood for 18 months, save for one blip of viral DNA that researchers studying the man suspect was a false signal. But such transplants are unsafe, can not be used widely and have failed in other patients. "It's been 10 years since the last success, and I was totally prepared for failure of the graft or return of the lymphoma", he says.

The donor-who was unrelated-had a genetic mutation known as "CCR5 delta 32", which confers resistance to HIV. "After 2 years, we'll be talking more about 'cure, '" Gupta says. It's a complex and risky procedure - even this successful patient suffered a period of graft versus host disease - and requires exact match donors from the minuscule portion of people who have the CCR5 mutation. After chemotherapy, he underwent a stem cell transplant in 2016 and subsequently remained on antiretroviral therapy for 16 months. However, because HIV remained undetectable, he is still considered clinically cured of his infection, according to his doctors.

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Timothy Henrich, a clinician at the University of California, San Francisco (UCSF), has seen HIV bounce back in two patients who had a conditioning regimen that impressively knocked down HIV reservoirs but whose transplants came from donors with working CCR5s.

"This tells us that the feasibility, and importantly, the availability of delivering this approach could possibly be achieved by the rapidly accelerating field of gene editing and related gene therapies".

This is obviously mind-blowing news, but there's a caveat: most experts agree that it can't be a solution for many HIV patients.

Bone-marrow transplantation is unlikely to be a realistic treatment option in the near future. "I think that finding a scalable cure that is safe and can be applied to a vast majority of individuals living with HIV is definitely attainable, but we have a lot more work to go".

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