Medicine

Second man seems to be free of AIDS virus after transplant

Second man seems to be free of AIDS virus after transplant

According to the New York Times, scientists are now monitoring 38 HIV positive patients, 32 of whom have been given bone-marrow transplants from a donor with the CCR5 gene mutation.

He underwent a so-called haematopoietic stem cell transplant in 2016 from a donor with two copies of a CCR5 gene variant, which is resistant to most HIV-1 virus strains.

"If we can understand better why the procedure works in some patients and not others, we will be closer to our ultimate goal of curing HIV", said Cooke, who was not involved in the case study.

The study describes an anonymous male patient in Britain who was diagnosed with HIV infection in 2003 and had been on antiretroviral therapy since 2012. A decade after Brown became famous thanks to a stem cell transplant that eliminated his HIV infection, a similar transplant from a donor who has HIV-resistant cells appears to have cured another man, dubbed the "London patient".

Adalja noted that although the Berlin patient and the London patient received similar treatments, the Berlin patient's treatment was more intense - he received two bone-marrow transplants in addition to whole-body irradiation (radiation exposure to the whole body). The transplanted immune cells now seem to have replaced his vulnerable cells; they have also cured his cancer without any side effects.

Graham Cooke, from Imperial College London, said: "This second London patient, whose HIV has been controlled following bone marrow transplantation, is encouraging".

The London, U.K. patient has not been identified. HIV can mutate from using CCR5 to relying on CXCR4, but in order to do that, it needs to be actively replicating.

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Scientists are looking at finding a way to inject a patient with modified immune cells that can resist the HIV virus.

His doctors found a donor with a gene mutation that confers natural resistance to HIV. CCR5 is also the gene that Chinese researcher He Jiankui tweaked in embryos to give them a genetically-engineered resistance to HIV infection throughout their lifetimes.

Experts have also warned that the treatment carried out is not practical or healthy for people living with HIV, reports the BBC, but could ultimately help to find a cure.

It's a matter of semantics, says Dr. Steven Deeks, professor of medicine at the University of California, San Francisco and one of the doctors who treated Brown.

Almost 37 million people worldwide have been infected with HIV, and scientists are struggling to find a cure for the disease - a virus notorious for hiding in the body and evading attempts to flush it out.

"I think so." He says he believes that some HIV still remains in the London patient's body, but that because his immune system is now impervious to the virus, the HIV is marooned - like a castaway on a remote island who can not swim. This makes it a tricky and unfeasible option as a treatment for other HIV-positive patients in the near future. "After a ten year gap it provides important confirmation that the "Berlin patient" was not simply an anomaly". He was then treated with radiation and chemotherapy in order to erase his immune system so it could be reconstituted with donated stem cells taken from a donor who was immune to HIV.

"I think this does change the game a little bit", Gupta opined to NYT of the new patient, who had less invasive treatment than Brown. However, the team behind this success are advising caution, saying it is too early to call it a cure.