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London HIV patient becomes world's second AIDS cure hope

10 March 2019

A transplant of bone marrow stem cells from a donor with that specific mutation has seemingly cured the man, known only as the "London patient", of his HIV infection.

Ten years ago, Timothy Brown - dubbed the "Berlin patient" - became the first person to be effectively cured of HIV using a similar method.

The case report is carried out by researchers at University College London (UCL) and Imperial College London, together with teams at the University of Cambridge and the University of Oxford. People who have two mutated copies of the CCR5 allele are resistant to the HIV-1 virus strain that uses this receptor, as the virus can not enter host cells. The procedure successfully replaced the patient's white blood cells with the HIV-resistant variant.

The new case "shows the cure of Timothy Brown was not a fluke and can be recreated", Dr. Keith Jerome, Fred Hutchinson Cancer Research Center in Seattle, told the AP.

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).

Close to 37 million people are living with HIV worldwide, but only 59 percent are receiving ARV.

"This second documented case does reinforce the message that HIV cures are possible", says infection and immunity researcher Anthony Kelleher from UNSW in Australia, who wasn't involved with the study.

It was only in 2016 that he was able to access the stem cell donation because he was seeking treatment for the cancer, not the HIB. "This is likely to be many years away and until then, the emphasis needs to remain on prompt diagnosis of HIV and initiation of life-long combination antiretroviral therapy (cART). cART is highly effective both in restoring near normal life expectancy and preventing onward transmission to others".

"Common to both approaches is the presence of a modified gene in our immune system (CCR5) that is necessary for HIV infection".

"I feel a sense of responsibility to help the doctors understand how it happened so they can develop the science", the anonymous "London patient" tells The New York Times in an email.

Sharon Lewin, an expert at Australia's Doherty Institute and co-chair of the International AIDS Society's cure research advisory board, said: "We haven't cured HIV, but (this) gives us hope that it's going to be feasible one day to eliminate the virus". Most people with HIV respond well to daily antiretroviral treatment.

This breakthrough doesn't mean there is a cure for HIV, however, as doctors warn that bone marrow transplants are too risky for healthy people living with HIV to undergo.

The London, U.K. patient has not been identified.

"Today's news is a welcome development for many people living with HIV, but we must not take our eye off the ball in ensuring we use the tools we already have that can help us towards zero new transmissions". They will present what they have learned so far in the next days in the journal Nature, and at a medical conference in the US city of Seattle, Washington.

AIDS researchers have known about the this CCR5 mutation for years and have tried to think of ways to exploit it as a treatment for HIV.

The new case, the "London patient", was diagnosed with HIV in 2003, and put on antiretrovirals in 2012.

However, news that a second person may have been "cured" demonstrates that the Berlin Patient was not an anomaly.

London HIV patient becomes world's second AIDS cure hope