“London patient” becomes second person to be cured of AIDS after stem cell therapy. It has helped them put their infection under remission without medication. The breakthrough offers hope for a potential cure using gene manipulation for an infection. Concept that scientists will one day be able to end AIDS, the doctors said, but does not mean a cure for HIV has been found.
An HIV-positive man in Britain has become the second known adult worldwide to be cleared of the AIDS virus after he received a bone marrow transplant from an HIV resistant donor, his doctors said.
Almost three years after receiving bone marrow stem cells from a donor with a rare genetic mutation that resists HIV infection – and more than 18 months after coming off antiretroviral drugs – highly sensitive tests still show no trace of the man’s previous HIV infection.
“There is no virus there that we can measure. We can’t detect anything,” said Ravindra Gupta, a professor and HIV biologist who co-led a team of doctors treating the man.
The case is a proof of the concept that scientists will one day be able to end AIDS, the doctors said, but does not mean a cure for HIV has been found.
Gupta described his patient as “functionally cured” and “in remission”, but cautioned: “It’s too early to say he’s cured.”
The man is being called “the London patient”, in part because his case is similar to the first known case of a functional cure of HIV – in an American man, Timothy Brown, who became known as the “ Berlin patient” when he underwent similar treatment in Germany in 2007 which also cleared his HIV.
Brown, who had been living in Berlin, has since moved to the United States and, according to HIV experts, is still HIV-free.
Some 37 million people worldwide are currently infected with HIV has killed around 35 million people worldwide since it began in the 1980s. Scientific research into the complex virus has in recent years led to the development of drug combinations that can keep it at bay in most patients.
Gupta, now at Cambridge University, treated the London patient when he was working at University College London. The man had contracted HIV in 2003, Gupta said, and in 2012 was also diagnosed with a type of blood cancer called Hodgkin’s Lymphoma.
In 2016, when he was very sick with cancer, doctors decided to seek a transplant match for him. “This was really his last chance of survival,” Gupta told Reuters in an interview.
The donor – who was unrelated – had a genetic mutation known as ‘CCR5 delta 32’, which confers resistance to HIV.
The transplant went relatively smoothly, but there were some side effects, including the patient suffering a period of “graft-versus-host” disease.
Most experts say it is inconceivable such treatments could be a way of curing all patients. The procedure is expensive, complex and risky. To do this in others, exact match donors would have to be found in the tiny proportion of people — most of them of northern European descent — who have the CCR5 mutation that makes them resistant to the virus.
Specialists said it is also not yet clear whether the CCR5 resistance is the only key – or whether the graft versus host disease may have been just as important. Both the Berlin and London patients had this complication, which may have played a role in the loss of HIV-infected cells.
Sharon Lewin, an expert at Australia’s Doherty Institute and co-chair of the International AIDS Society’s cure research advisory board, told Reuters the London case points to new avenues for study. “We haven’t cured HIV, but (this) gives us hope that it’s going to be feasible one day to eliminate the virus,” she said.
Gene manipulation, like any experimental technology, comes with several caveats, including concerns about the “off target effects” that can cause adverse mutations, including cancer.