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Second man seems to be free of AIDS virus after transplant

08 Mars 2019

Here's what to know about the landmark case. Doctors made the transplant and blasted Brown, known then as "the Berlin patient", with radiation and powerful immune-suppressing meds to keep his body from rejecting the transplant.

He had chemotherapy to treat the Hodgkin's cancer and, in addition, stem cells were implanted into the patient from a donor resistant to HIV, leading to both his cancer and HIV going into remission.

Any story about an HIV cure is bound to stir excitement.

The London patient, on the other hand, was able to undergo a far gentler regimen with similar results, though the broad therapeutic strokes were more or less equivalent.

Physicians at the University of Cambridge in the United Kingdom replaced the patient's white blood cells with HIV-resistant cells via a stem cell transplant. This week Brown celebrated 12 years free of HIV at a community cure workshop prior to the conference.

Globally, 36.9 million people were living with HIV at the end of 2017, with 59 percent receiving antiretroviral treatment, according the World Health Organization.

Does this mean HIV has been cured?

Brown was only treated this way because his prospects were so dire otherwise. "Is that a cure?"

For just the second time since the global epidemic began, a patient appears to have been cured of infection with H.I.V., the virus that causes AIDS, scientists reported on Tuesday. The gene is known to create a protein that is crucial for HIV to invade blood cells. The additional risks of aggressive chemotherapy and possible periods of immune dysfunction also point towards the lower-risk anti-retroviral drugs being a better and cheaper option.

A complete cure for H.I.V. has eluded researchers for decades, due to its quick mutation rate and its supreme ability to infect and kill immune cells. "It may persist there for quite some time, but who cares?"

The donor - who was unrelated - had a genetic mutation known as "CCR5 delta 32", which confers resistance to HIV.

Could the patient's HIV come back?

He underwent a bone marrow transplant to treat not AIDS but leukemia. HIV can mutate from using CCR5 to relying on CXCR4, but in order to do that, it needs to be actively replicating.

Institutions involved in the case include Imperial College London, University College London, and Cambridge and Oxford University.

Both the London and the Berlin patients were on these antiretrovirals when they developed life-threatening blood cancers. Infected people still have reservoirs of virus in their bodies, raising the prospect that a drug-resistant strain could ultimately evolve.

Brown was diagnosed with 1995. Doctors haven't been clear on why the patient hadn't started ART when he was diagnosed with the disease.

Can bone marrow transplants eliminate HIV for a large number of people?

The ICISTEM group has screened over two million stem cell donors to identify those with the CCR5-delta32 mutation, increasing the chance that new candidate transplant recipients may receive donor cells with this rare genetic mutation. "We're fortunate now in that we can have many patients treated with one pill, once a day". Knowing that the CCR5 gene plays such a substantial role may help scientists develop other forms of safe, cost-effective treatment in the future.

The CCR5 gene was thrust into the worldwide spotlight recently by the revelation that a Chinese scientist had attempted to edit human embryos to create the same deletion, with the hopes of creating babies that were immune to HIV.

Still, Fauci is hopeful that such approaches will eventually be available for HIV patients. "And we can apply that new knowledge to the development of strategies aimed at a more widely applicable cure".

Brown said he would like to meet the London patient and would encourage him to go public because "it's been very useful for science and for giving hope to HIV-positive people, to people living with HIV", he told The Associated Press Monday.

Second man seems to be free of AIDS virus after transplant