Second man seems to be free of AIDS virus after transplant

London HIV Patient Becomes World's Second Man To Be Cured Of AIDS Virus

Has a second person with HIV been cured?

Both the London and Berlin patients received stem cell transplants from donors carrying a genetic mutation that prevents expression of an HIV receptor, known as CCR5.

Timothy Brown, an American man, was known as "the Berlin patient" when he also received a bone marrow transplant for leukemia treatment in Germany 12 years ago. He is tested often, and his HIV viral load is undetectable.

The new case report comes more than 10 years after the first case, known as the "Berlin patient". Though they are calling it a "cure" in some public statements, the New York Times reports that in writing, and the forthcoming publication in science journal Nature, it will be referred to as "long-term remission". "But we can try to tease out which part of the transplant might have made a difference here, and allowed this man to stop his anti-viral drugs".

The second person, dubbed "The London Patient" was treated by specialists at at University College London and Imperial College in 2016, and has since shown no sign of the virus.

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

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. The transplanted immune cells, now resistant to HIV, seem to have fully replaced his vulnerable cells. "Those of us in the field have been waiting for a second cure via this approach", said Dr. Keith Jerome, one of the leaders of HIV cure research at the Fred Hutchinson Cancer Research Center. "I never thought that there would be a cure during my lifetime".

To test whether he was truly in HIV-1 remission, the London patient disrupted his usual antiretroviral therapy.

So far, its scientists are tracking 38 HIV-infected people who have received bone-marrow transplants, including six from donors without the mutation.

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This is obviously mind-blowing news, but there's a caveat: most experts agree that it can't be a solution for many HIV patients.

The London patient is 36 on this list.

Timothy Henrich, a clinician at the University of California, San Francisco (UCSF), has seen HIV bounce back in two patients who had a conditioning regimen that impressively knocked down HIV reservoirs but whose transplants came from donors with working CCR5s.

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

None of this guarantees that the London patient is forever out of the woods, but the similarities to Brown's recovery offer reason for optimism, Gupta said.

"I am an optimist because I'm a scientist and vice versa", Henrich said.

Scientists are also examining immune modifying therapies.

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