Second man seems to be free of AIDS virus after transplant

Henrietta Brewer
March 5, 2019

With the right kind of donor, his doctors figured, the London patient might get a bonus beyond treating his cancer: a possible HIV cure.

Timothy Ray Brown, an American man then living in Germany and widely known as the "Berlin patient," underwent a similar procedure in 2007 and is reportedly still HIV-free.

Usually, HIV patients expect to stay on daily pills for life to suppress the virus.

"This poses a particular challenge in developing countries", where millions are still not receiving adequate treatment, he added.

Some 37 million people worldwide are now infected with HIV and the AIDS pandemic has killed around 35 million people worldwide since it began in the 1980s. About 35 million others have died of AIDS in the past three decades. "Two factors are likely at play: The new bone marrow is resistant to HIV, and also, the new bone marrow is actively eliminating any HIV-infected cells".

After two bone marrow transplants, Brown was considered cured of his HIV-1 infection.

The case is a proof of the concept that scientists will one day be able to end AIDS, his doctors said, but does not mean a cure for HIV has been found.

Bone marrow transplants as an HIV cure is a treatment with harsh side effects, but The New York Times reported that scientists think giving patients similar HIV-resistant immune cells might do the trick.

"Finding a way to eliminate the virus entirely is an urgent global priority, but is particularly hard because the virus integrates into the white blood cells of its host", Gupta explained. "It shows the Berlin patient was not just a one-off, that this is a rational approach in limited circumstances", Daniel Kuritzkes, chief of infectious diseases at Brigham and Women's Hospital (who was not involved in the study), told the paper. Later, he was diagnosed with advanced Hodgkin's lymphoma. The donor - who was unrelated - had a rare genetic mutation known as "CCR5 delta 32", that resists HIV infection.

Reuters reports that the man, whose identity has not been revealed, has tested negative for the virus nearly three years after he received a bone marrow transplant from a donor with an HIV-resistant genetic mutation.

But replacing immune cells with those that do not have the CCR5 receptor appears to be key in preventing HIV from rebounding after the treatment.

Ten years ago, another patient in Berlin received a bone marrow transplant from a donor with natural immunity to the virus.

Brown remains uninfected as far as scientists can tell, and no HIV has been detected in the London patient's blood for 18 months, save for one blip of viral DNA that researchers studying the man suspect was a false signal. Brown and the London patient also suffered from graft-versus-host disease as the transplanted immune systems attacked other recipient tissues as foreign.

The research team is presenting the findings at the annual Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle, Washington.

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