Published: Thu, March 12, 2020
Sci-tech | By Patricia Wade

'London patient' cured of HIV reveals identity for the first time

'London patient' cured of HIV reveals identity for the first time

For the second time in history, a patient suffering from HIV, the AIDS-causing virus, has been cured of the infection, doctors said Tuesday. The "London patient" from Venezuela was a cancer survivor, who was mentioned in the headlines a year ago.

Castillejo's transplant was in May 2016. The man allegedly got sick with HIV in 2003, and he was later diagnosed with Hodgkin's lymphoma.

Four years later, he underwent bone marrow transplant to treat cancer and received stem cells from donors with a genetic mutation which prevents HIV from taking hold, News24 mentioned.

Speaking on the discovery, which had followed years of research and clinical tests, Ravindra Gupta, a researcher at the University of Cambridge, said it presents an "almost certain" cure for HIV. The first individual, Timothy Brown, the so-called Berlin Patient, recovered from the illness in 2011 following a similar course of treatment. This therapy included total body irradiation, two rounds of stem cell transplant from a donor who carried a CCR5Δ32/Δ32 gene, which is resistant to HIV and finally a chemotherapy drug regimen.

"But we need to also place it in context - curing people of HIV via a bone marrow transplant is just not a viable option on any kind of scale", she said.

A Briton man has become the second to be cured of HIV.

In an accompanying comment, Jennifer Zerbato, PhD, and Sharon Lewin, MD, PhD, both of the University of Melbourne in Australia, noted two important points: namely that the low levels of HIV DNA were found "not intact, consistent with archival fragments that can not replicate" and that based on a mathematical model, Gupta and colleagues calculated that the patient had "greater than 90% chimerism in circulating T cells", thus "the chance of future viral rebound while off ART [antiretroviral therapy] is negligible".

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"You'd have to weigh up the fact that there's a 10-percent mortality rate from doing a stem-cell transplant against what the risk of death would be if we did nothing", he said.

Long-term follow-up of the London patient suggests no detectable active HIV virus remains in the patient.

Targeting CCR5 with gene-editing is a controversial topic following the infamous case of Chinese doctor He Jiankui, who modified the genes of twin babies using CRISPR, sparking a backlash from the scientific community.

A linked commentary by Dr Jennifer Zerbato and Prof Sharon Lewin of the University of Melbourne and Royal Melbourne Hospital, who were not involved in the work, stressed that it is hard to define a "cure" for HIV, but noted that the absence of the active virus is, potentially, a better definition than no trace whatsoever. According to the Times story, he spoke with Brown repeatedly before deciding to reveal his identity. The team says that low levels of HIV DNA were found in the node tissue and in blood CD4 T cells while all other samples were negative for HIV DNA.

However, his doctors say what healed him was not the HIV drugs.

The donors had an uncommon gene that gives them protection from the virus. He stopped antiretroviral therapy at the time of his first transplant, but his viral load did not rebound as expected. "This is not a treatment that would be offered widely to patients with HIV".

To be cured of both cancer and HIV was "surreal", Castillejo told the newspaper.

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