Second man seems to be free of AIDS virus after transplant

Second man seems to be free of AIDS virus after transplant

Timothy Ray Brown's HIV cure may no longer be unique.

The title is similar to the first known case of a cured HIV-positive patient.

A London man appears to be free of the AIDS virus after a stem cell transplant - marking a potential milestone breakthrough, 12 years after the first success. "It tells us that Timothy Brown wasn't a one-off".

"By achieving remission in a second patient using a similar approach, we have shown that the Berlin patient was not an anomaly, and that it really was the treatment approaches that eliminated HIV in these two people", says virologist Ravindra Gupta from University College London. But the transplants were meant to treat cancer in the patients, not HIV.

For this reason, he's often described as being the first patient "cured" of HIV, although technically that's incorrect, since remission and cures are not the same thing (as sometimes remissions are not complete, if the viral load stages a resurgence). The team also found that his white blood cells now can not be infected with CCR5-dependent HIV strains, indicating the donor's cells had engrafted.

Gupta said the London patient was "functionally cured" and is in remission, but said it was too early to officially say he is cured. Gupta prefers to say the man is instead in long-term remission, in part because the team hasn't looked at tissues other than the patient's blood. "I never thought that there would be a cure during my lifetime".

He later developed cancer and agreed to undergo a bone-marrow transplant for treatment.

In some of the past transplant failures, the donor did not have a mutated CCR5, but the conditioning regimen seemed to have significantly reduced the "reservoirs" of cells in the recipient that have latent HIV infections, invisible to the immune system. Brown had to have a second stem cell transplant when his leukemia returned.

The London patient has answered that question: A near-death experience is not required for the procedure to work. The man suffered from post-procedure complications whereby the donor's immune cells attacked his own.

The "London patient" told the paper that it was "surreal" and "overwhelming" to learn that he could be cured of H.I.V. and cancer. The London patient is one of 40 in the study.

The Berlin patient was actually an American (real name: Timothy Ray Brown) diagnosed with HIV while living in Germany. "Durable engraftment" of the CCR5 mutants is key to a cure, he concludes. The surprise success now confirms that a cure for HIV infection is possible, if hard, researchers said. "That could be a fantastic way forward", Johnston says.

There has been only one documented case of HIV, which causes acquired immune deficiency syndrome (AIDS), being cured.

The donor-who was unrelated-had a genetic mutation known as "CCR5 delta 32", which confers resistance to HIV. The researchers expand the modified cells and then reinfuse them into their patients with the hope that they will engraft and populate the blood.

Numerous attempts to replicate the procedure have not been successful until now, with the latest case dubbed that of the "London patient".

"I am an optimist because I'm a scientist and vice versa", Henrich said. The patient was receiving the bone marrow transplant for cancer. The patient, who chose to be anonymous, was cured after a stem cell transplant.



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