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The London Patient and an HIV ‘Cure’: What You Need to Know

10 March 2019

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.

Publishing in the science journal "Nature", researchers from University College London detail how they have achieved HIV remission in a man known publicly as the London Patient, making this the second of only two documented prolonged cases of remission of this kind in the world.

All of that seemed to change when in 2008 at the Conference on Retrovirus and Opportunistic Infections in Boston, Massachusetts, the news broke of the Berlin patient, named Timothy Ray Brown, who seemed to have been cured of his HIV. In fact, Timothy Ray Brown, the original patient functionally cured of HIV, also known as the Berlin patient, nearly died from a host donor rejection during his treatment.

"The first is that CCR5-negative cells are resistant to HIV", she said.

Such transplants are unsafe and have failed in other patients.

A German man could be the third person in history to ever be cured of the HIV virus, researchers announced this week. This CCR5 receptor mutation - present in about 1 percent of people of European descent - prevents HIV viruses from entering immune cells.

Stem cell transplants or bone marrow transplants are painful, costly and time consuming-and there are several ways in which such transplants go wrong. The Berlin patient had his immune cells replaced with ones from a donor with a genetic mutation that disables a receptor called CCR5.

An HIV-infected patient has successfully cleared the AIDS virus from his body, United Kingdom doctors reported this week. The man had contracted HIV in 2003, Gupta said, and in 2012 was also diagnosed with a type of blood cancer called Hodgkin's Lymphoma. Lastly, the marrow donors had a particular mutation which eliminated HIV's ability to attach to host cells. Additional follow-up research must be done to insure that the new bone marrow produced reconstitutes the patient's immune system with the CCR5 genetic mutation so that HIV treatment can be stopped.

"The Human Immunodeficiency Virus (HIV) attacks and weakens the immune system, reducing its ability to fight diseases or infections", Girish Badarkhe, Haematologist at HCG Cancer Centre, Bengaluru, told IANS. For starters, there are two main variants of HIV, one of which is much rarer than the other - and all three patients had the rare variant.

He did not experience HIV rebound, during the 18 months he did not take anti-viral medication. Finding the right regimen and staying on it can make the virus undetectable in a person's blood, meaning both that they stay healthy and that they cannot transmit the virus to other people. The treatment is very intense and is not considered appropriate for most people living with HIV.

After so many failed attempts at replication, the London patient is giving researchers hope that Brown's case was not just luck.

"The reason we know that this appears to be effective is that these people are no longer taking their anti-retroviral agents - which stops the virus from replicating - but nevertheless using very sensitive approaches, the virus can not be detected in their body at present".

The London Patient and an HIV ‘Cure’: What You Need to Know