Health Care

Second person in history reportedly cured of HIV

Second person in history reportedly cured of HIV”

Timothy Ray Brown's HIV cure may no longer be unique.

A man in the United Kingdom may be the second person ever to be cured of HIV.

"It was done with Timothy Ray Brown, and now here's another case - ok, so now what?"

Brown, though, had undergone more severe treatment than the London patient and for a while researchers believed that his near-death experience was key to curing HIV.

Both the London and Berlin patients received stem cell transplants from donors carrying a genetic mutation that prevents expression of an HIV receptor, known as CCR5.

After the bone marrow transplant, the London patient remained on ARV for 16 months, at which point ARV treatment was stopped. As such, this procedure is unlikely to become a realistic treatment for HIV in the future-especially given that the antiretroviral drugs prescribed for the infection have been shown to be extremely effective.

Ravindra Gupta, a professor and HIV biologist, took charge of the team of doctors treating the man in question.

Gupta describes the patient as "in long-term remission" and "functionally cured", although he is hesitant to use the term "cured" at this stage: "After 2 years, we'll be talking more about 'cure'". Other, more generally applicable strategies that may, in time, lead to a cure are also being investigated.

According to Professor Gupta, the London patient was HIV-positive since 2003, before he was diagnosed with blood cancer Hodgkin's Lymphoma in 2012. But while the treatments control the virus, they don't eliminate it. Gupta did not expect this transplant to work either.

Hardy raised another question that has yet to be answered: Both the Berlin patient and the second man developed graft-versus-host disease after their transplants.

But in the case of the London patient, the treatment worked.

"This case tells us that there is no magic conditioning regimen", Lewin says. A cure for HIV does not exist, but medications known as anti-retroviral therapy or ART can significantly slow the illness's advance, potentially extending patients' lives by decades. But with the mutated CCR5, Brown's immune cells became molecular fortresses that HIV couldn't penetrate - which meant the transplant essentially cured him of his infection. "That could be a fantastic way forward", Johnston says.

Blood cells of an infected person are replaced by someone who is immune to HIV through a genetic mutation which stops the virus attaching to cells. The researchers expand the modified cells and then reinfuse them into their patients with the hope that they will engraft and populate the blood.

The first, the Berlin Patient, also received a stem cell transplant from a donor with two CCR5 alleles, but to treat leukaemia.

"Personally I think there is probably some virus somewhere in the body, but it's absolutely trapped", says Deeks.

The London patient, who has not been named, told The New York Times he feels a "sense of responsibility to help the doctors understand how it happened to so they can develop the science". "I did a little happy dance when I read the paper", she says.

"If you are saying that bone marrow transplants are now going to be a viable way to cure large numbers of people with HIV in a scalable way, the answer to that is absolutely not", says Dr. Anthony Fauci, director of the National Institutes of Health's National Institute of Allergy and Infectious Diseases.



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