Breakthrough: A Second HIV Patient Has Gone Into 'Long-Term' Remission

Henrietta Brewer
March 6, 2019

The Berlin Patient later came forward as American Timothy Ray Brown and though doctors have made various attempts to replicate his treatment in the intervening decade, none have succeeded until now.

Brown was given two stem cell transplants and radiotherapy for leukaemia, which is considered a much more aggressive form of treatment. He remains free of HIV today. Essentially, the mutation prevents HIV from being able to get inside people's cells, so it can not cause infection.

"It was done with Timothy Ray Brown, and now here's another case - ok, so now what?" The investigators plan to publish their report on Tuesday in the journal Nature and are to present some of the details at the Conference on Retroviruses and Opportunistic Infections in Seattle, the Times reported.

Breakthrough: A Second HIV Patient Has Gone Into 'Long-Term' Remission

Gertrude Asiimwe, Human Diagnostics Uganda Customer Relations Officer demonstrates how an oral HIV self-testing kit is used during an exhibition in Kampala, capital of Uganda, July 17, 2017. Also, lead researcher Ravindra Gupta told Wired the transplant was a "last chance of survival" for a patient with Hodgkin's lymphoma. After standard treatments failed, they gave the patient a stem-cell transplant - essentially killing off his old immune system and giving him a new one. The donor, who was unrelated, had a genetic mutation known as "CCR5 delta 32", which confers resistance to HIV.

The Trump administration plans to eliminate the virus once and for all with the expansion of four key strategies-diagnose, treat, protect, and respond-that will be implemented across the nation within the next 10 years, according to a blueprint (pdf) of the proposal released by HHS. The London Man has not been on Anti-Retroviral Therapy (ART) for 18 months.

"It's not a cure yet, but 18 months is a fairly long time without a rebound", Kiem said.

Some companies are researching gene therapy techniques, but they remain far from developing a cure for widespread use.

"This is a highly significant study", said Aine McKnight, a professor of viral pathology at Queen Mary University of London in a statement.

"This tells us that the feasibility, and importantly, the availability of delivering this approach could possibly be achieved by the rapidly accelerating field of gene editing and related gene therapies". For now, its use is restricted to those who need the transplant for other reasons, not for HIV alone, said Henrich, who was not involved in the new case study.

CCR5 is on the surface of white blood cells, and HIV uses it to enter a cell.

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. However, the team behind this success are advising caution, saying it is too early to call it a cure. It is a proof of concept that may prove valuable.

The transplant was relatively uncomplicated, but with some side effects including mild graft-versus-host disease, a complication of transplants wherein the donor immune cells attack the recipient's immune cells. The problems cleared up without intervention, though, and the patient was left with immune cells that lacked the protein used by HIV.

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