A cure for HIV? Feasible but not yet realized

A cure for HIV? Feasible but not yet realized

A cure for HIV? Feasible but not yet realized

A London man's H.I.V.is in long-term remission following a bone marrow stem cell transplant, making him only the second individual in history to be effectively cured of the virus.

Not coincidentally, the stem cells that both patients received in the transplant came from donors with a double set of this rare CCR5 mutation.

Gupta described his patient as "functionally cured" and "in remission", but cautioned: "It's too early to say he's cured".

"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", said Sharon Lewin, director of the Peter Doherty Institute for Infection and Immunity at the University of Melbourne.

However, Gupta and his team emphasised that bone marrow transplant is not a viable option for HIV treatment. AsVox's Julia Belluz reports, the Londoner, diagnosed with Hodgkin's lymphoma in 2012, opted for a May 2016 transplant after failing to respond to chemotherapy. He underwent intensive conditioning chemotherapy and whole-body radiation therapy to kill off his cancerous immune cells, allowing the donor stem cells to rebuild a new HIV-resistant immune system.

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The CCR5 gene, and the eponymous cell it codes for, nearly certainly play a crucial role in the collateral HIV cure.

There is now no cure, and UNAIDS is working to ensure that all people living with and affected by HIV have access to life-saving HIV prevention, treatment, care and support services.

"The first is that CCR5-negative cells are resistant to HIV", she said.

"Right now, we're at a point in the epidemic where people see viral suppression as a functional cure, so there's not as much interest in cure research as there used to be", said Andrew Spieldenner, a professor of communication at California State University San Marcos and the chair of US People Living with HIV Caucus.

But the London patient's conditioning treatment was far milder than Brown's, leading many to conclude this was probably not responsible for vanquishing the HIV virus. More recently, researchers reported that a bone marrow transplant recipient in Minnesota had viral remission lasting almost 10 months after an analytic treatment interruption, but he too ultimately experienced viral rebound.

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As of 2017, there were approximately 36.9 million people worldwide living with HIV/AIDS. "I never thought that there would be a cure during my lifetime".

The research team for the London patient will present their findings at the annual Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle, Washington.

All three cases have involved patients receiving cancer treatment separate to their HIV diagnosis. However, this new case adds to the evidence that using gene therapy to delete CCR5 receptors from T cells may be a feasible approach.

Mark Dybul, Co-Chair of the Towards an HIV Cure initiative, said in spite of the great success of ART, there remains a high need for a cure for HIV, especially in low-income settings.

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