Medicine

Stem cell patient 'cured' of HIV

Stem cell patient 'cured' of HIV

Given recent disappointments after hematopoietic stem cell transplantations in people living with HIV, the team reporting on remission of the London patient does not describe their patient as cured.

It's too early to say whether the patient has been "cured". Almost one million people die every year from HIV-related causes.

Current antiretroviral treatments make living with the virus much more manageable to when doctors first began trying to treat HIV and Aids - unlike a few decades before, a diagnosis is no longer a death sentence.

While a second patient experiencing HIV viral remission with a slightly less toxic cancer treatment is certainly encouraging progress, an 18-month remission does not equal a cure. He was diagnosed with HIV in 2003 and started taking drugs to control the infection in 2012. It involved the destruction of his immune system and transplanted stem cells with a gene mutation called CCR5 that resists HIV.

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. Otwoma said although there has been a notable decline in new HIV infections, continued effort is still needed to develop an efficacious, accessible and affordable HIV vaccine.

Since the Berlin patient was cured, stem cell therapy and BMT have failed for many HIV-infected people with blood cancer, with the virus rebounding in some cases, and patients succumbing to their leukaemia or lymphoma in others. Traces of HIV were seen in Brown's blood a few years after he stopped antiretroviral therapy.

He added that both the Berlin and London patients had this complication, which could have played a role in the loss of HIV-infected cells.

The first patient who successfully used the treatment was the 'Berlin Patient' back in 2008.

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"They used a reduced intense conditioning regimen but I think that had no influence on the outcome", he said.

"These two patients had progressive cancer that made them eligible for treatment that's no walk in the park, with a mortality rate of 10 to 25 percent", Dr. John Mellors of the University of Pittsburgh said at a CROI press conference.

Now doctors have said that, together, the cases provide proof of concept that a cure may be possible for everyone, although the invasive treatment would have to be adapted radically. Patient is in HIV remission 18 months later. Unlike Brown, the man received milder chemotherapy and did not undergo whole-body radiation to completely kill off his cancerous immune cells. The X4 form of HIV, which uses a different protein, would not be tackled by treatment based on the delta 32 mutation. This new success however has shown that it may work in some patients.

"There are actually many strategies right now that are currently being pursued", Henrich said.

Even so, the bone-marrow transplant that appears to have eliminated the virus is too risky, complicated and expensive to serve as a widespread cure.

Scientists are also examining immune modifying therapies.

"I'd rather be on the single pill a day with very little toxicities than risk something as draconian as a transplant", said Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases. "I do have hope".

"I did not want to be the only person in the world cured of HIV", Brown wrote in a medical journal in 2015, explaining why he chose to reveal his identity.