Published: Thu, March 07, 2019
Health Care | By Cedric Leonard

Second Patient Achieves Sustained HIV-1 Remission After Treatment Cessation

Second Patient Achieves Sustained HIV-1 Remission After Treatment Cessation

A London man has become the second person in "sustained remission" from the virus after receiving a stem cell transplant and undergoing chemotherapy, according to a new study in Nature. That year, he was also diagnosed with stage 4 Hodgkin's lymphoma.

Ravindra Gupta, an HIV biologist who helped treat the man, told Reuters that his patient is "in remission" but warned that it's "too early to say he's cured". "Two factors are likely at play: The new bone marrow is resistant to HIV, and also, the new bone marrow is actively eliminating any HIV-infected cells". These mutations are in a gene called CCR5, which HIV normally recognizes in immune cells and uses like a key to enter and infect them. 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.

Compared to Brown, the London patient had a less punishing form of chemotherapy to get ready for the transplant, didn't have radiation and had only a mild reaction to the transplant. He waited about nine years after being diagnosed with HIV to start anti-HIV drug therapy.

The donor, researchers noted, possessed 2 mutated copies of the CCR5 allele - similar to the donor in the first case of HIV remission.

After examining over and over the "London patient's" blood to look for H.I.V., the scientists could not find any circulating virus.

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Speaking with CNN, Dr. Timothy Henrich of the University of California, San Francisco's Department of Medicine - who wasn't involved with the study - said of the new findings that "I do have hope" and "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". In both instances, the patients received a bone marrow transplant to treat cancer.

A digitally colorized scanning electron microscopic (SEM) image depicts a single, red colored H9-T cell that had been infected by numerous, spheroid shaped, mustard colored human immunodeficiency virus (HIV) particles attached to the cell's surface membrane, as seen in this 2012 image obtained from the National Institute of Allergy and Infectious Diseases (NIAID) located in Bethesda, Maryland, U.S., on March 5, 2019.

Gupta and his team emphasized that bone marrow transplant - a risky and painful procedure - is not a viable option for HIV treatment.

After the bone marrow transplant, the London patient remained on ARV for 16 months, at which point ARV treatment was stopped. "After a ten year gap it provides important confirmation that the "Berlin patient" was not simply an anomaly". In these two cases, doctors selected a donor who had an uncommon mutation that made them virtually immune to HIV infection and this mutation was passed on to the recipient. "So many things have happened that I thought were out of our realm of possibility", he says.

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