Second patient ever in HIV remission after stem cell transplant

Second patient ever in HIV remission after stem cell transplant

Second patient ever in HIV remission after stem cell transplant

A man in London has become only the second person to achieve remission from HIV infection, researchers from the United Kingdom reported Tuesday. The transplanted stem cells can also produce immune cells that go on to attack their new host, a problem called graft vs. host disease. The title is similar to the first known case of a cured HIV-positive patient.

Graham Cooke, from Imperial College London, said: "This second London patient, whose HIV has been controlled following bone marrow transplantation, is encouraging". He was given a transplant of hematopoietic stem cells from a donor with two copies of a mutation relating to CCR5-a protein on the surface of white blood cells plays a role in the immune system.

Around 100,000 people in Britain are living with HIV and the team is now looking into whether it is possible to simply knock out the receptor through gene therapy. Although the interventions that the two patients received could only be used on a tiny fraction of the 37 million HIV-infected people worldwide, their stories point to cure strategies that could be more widely applicable.

Using bone marrow transplants to cure HIV in everyone who has the virus, though, remains impractical, expensive, and risky.

Doctors found a donor with a gene-mutation that is naturally resistant to the HIV virus, according to the findings. His drug regiment was much less harsh than the only other known patient who was cured of HIV.

However, the researchers stress that such a bone-marrow transplant would not work as a standard therapy for all patients with HIV.

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The IAS welcomed the announcement saying that the man has remained in HIV remission and off antiretroviral therapy (ART) 19 months after receiving a bone marrow transplant from a CCR5 negative donor for Hodgkin's lymphoma. He was diagnosed with HIV in 2003.

Gupta has described the man as "functionally cured" and "in remission".

Acute myeloid leukemia patient Timothy Brown, who became known as the "Berlin patient," was treated aggressively more than a decade ago in an HIV-curing approach that hasn't been successfully repeated until Ravindra Gupta and colleagues showed the effectiveness of a less aggressive form of treatment. Beforehand, each had been treated with toxic chemicals in a "conditioning" regimen meant to kill off their existing cancerous bone marrow cells.

"As the authors caution, it is still too early to be certain that this second patient has been cured of HIV". Finding ways to treat people infected with HIV with some infusions of mutated CCR5 cells that block infection seems to make more sense now. He was called the "Berlin patient" and was later identified as Timothy Ray Brown.

"Although it is not a viable large-scale strategy for a cure, it does represent a critical moment in the search for an HIV cure", IAS president Anton Pozniak. The new patient had none of this HIV variant, which probably contributed to the success of this treatment.

The new patient also tells us that we don't necessarily have to be that aggressive when wiping out a person's immune system prior to the transplant.

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