A Second Patient Is Free of HIV After Stem Cell Therapy

An international team of scientists announced that a person with HIV appears to be virus-free after receiving a stem-cell transplant that replaced his white blood cells with HIV-resistant cells. The patient  – known as the “London” patient – was able to stop taking antiretroviral drugs 18 months ago and the virus has shown no sign of returning.

This stem-cell treatment for HIV was first used 12 years ago on Timothy Ray Brown, known as the “Berlin” patient, who is still virus free and considered cured. But researchers have said that it is too early to say if the new patient can also be considered cured.

So far, the latest patient to receive the treatment is showing a response similar to Brown’s, Andrew Freedman, a clinical infectious-disease physician at Cardiff University in the UK who was not involved in the study told Nature.

The London patient, like Brown, suffered from a rare form of blood cancer that was not responding to chemotherapy. He required a bone-marrow transplant after his own blood cells were destroyed and replenished with stem-cells from a healthy donor.

The team that was led by Ravindra Gupta, an infectious-disease physician at the University of Cambridge, UK didn’t just choose any donor. It picked a donor who had two copies of a mutation in the CCR5 gene that gives people resistance to HIV infection, according to Nature. This gene code is known to be resistant to HIV and is found in only 1 percent of people of European descent.

HIV completely disappeared from the patient after the treatment and has still not rebounded 18 months later.

“The London patient is the second HIV-positive man considered to be in prolonged remission after a bone marrow transplant from a CCR5 negative donor,” Maria Papathanasopolous, director of the Wits University’s HIV Pathogenesis Research said in a Wits University press release.

An additional patient – known as the “Düsseldorf” patient has been off his anti-viral meds for three-and-a-half months, according to the press release. The results of this study were presented at the Conference on Retroviruses and Opportunistic Infections, in Washington, 4-7 March 2019, and published in Nature.

Gupta presented a potential cure of HIV after stem cell transplantation in his “London” patient, while Dr. Björn Jensen from Düsseldorf University found his “Düsseldorf patient” also potentially cured, according to the university.

Both the London patient and the Düsseldorf patient were registered with the IciStem program. IciStem is the International Collaboration to guide and investigate the potential for HIV cure by stem cell transplantation according to the university. More than 22,000 donors with the gene defect have been registered, and there are now 39 patients who have received transplants.

Gupta said in the study that the latest patient received a less aggressive treatment than Brown to prepare for the transplant. The new patient was only given a regimen consisting of chemotherapy alongside a drug that targets cancerous cells, while Brown received radiotherapy across his entire body in addition to a chemotherapy drug. This proves that HIV patients would not necessarily have to undergo an aggressive treatment.

While this is really good news, this type of treatment is not usable for most people with HIV who do not have cancer and do not need bone-marrow transplants. “If you’re well, the risk of having a bone-marrow transplant is far greater than the risk of staying on tablets every day,” Graham Cooke, a clinical researcher at Imperial College London said.

While there is not one size fits all cure for HIV, new successes show that new transmission rates are going down, new medications are working to keep people healthier much longer, and new research is looking for a cure. This is all very inspiring news.

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