Medicine

A Third Person Is Reportedly HIV-Free After a Bone Marrow Transplant

A Third Person Is Reportedly HIV-Free After a Bone Marrow Transplant

A bone marrow transplant is never done on patients who only have HIV alone.

Yet even with this life-extending treatment, a functional HIV cure, defined as when someone with HIV no longer tests positive for the virus and does not need to take these medications, has remained elusive.

The announcements come a decade after Timothy Brown, a patient in Berlin, became the first person to "beat" HIV after receiving a stem cell transplant in 2007.

"The combination is paradigm shifting", Chloe Orkin, an HIV researcher at Queen Mary University of London who reported the trial findings at a Seattle conference, told Nature.

This approach is not practical for treating most patients with HIV, but it may one day lead to finding a cure.

On Monday, doctors revealed a second patient, called the "London patient", had been off his antiviral medications for 18 months following his bone marrow transplant cancer treatment and had no signs of HIV. It is not sustainable, because the CCR5 genetic mutation is also extremely rare, and it is present only in less than 5 percent of individuals born of European dissent.

This complex treatment involves destroying a person's own immune system with high doses of chemotherapy or radiation.

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"This will inspire people that cure is not a dream", Wensing said.

Stem cell transplants or bone marrow transplants are painful, costly and time consuming-and there are several ways in which such transplants go wrong.

The two recent cases are part of the IciStem program, which is a collaborative venture of researchers and clinicians dedicated to HIV eradication, according to a release from IciStem. "Meanwhile focus needs to be on diagnosing HIV patients promptly and starting them on the lifelong cART treatment to help prevent further spread of the virus and provide the opportunity for those infected to live near normal life expectancy".

While it proved to be successful for the Berlin, London, and Düsseldorf patients, the strategy used for these cases are not the way to eradicate HIV on a large scale.

The Dusseldorf patient also received a bone marrow transplant from a donor with the CCR5 mutation. Much can be learned from this research, and it is clear that modifying the outside coating of T4 cells so that they lack the receptors, which the HIV virus uses to attach to and then enter the CD4 cells, is an important area for future cure research. "At the moment HIV isn't cured". Though their procedures were different from those the London Patient and the Berlin Patient, this demonstrates that caution is critical when we talk about this as a "cure". This renders them resistant to most HIV infection.

The third patient, from Dusseldorf, had apparently been HIV-free for three months, with no evidence of HIV in the gut and lymph nodes.