HIV case may be a second cure

03/08/2019 04:00 | 2

HIV case may be a second cure

Ten years after the first confirmed case of an HIV-infected person being rid of the deadly disease, a man known only as the "London patient" has shown no sign of the virus for almost 19 months. Their white blood cells were replaced with HIV-resistant versions, but the authors say it is still too early to say with certainty that he has been cured of HIV, and will continue to monitor his condition.

A London-based cancer patient that received a bone marrow transplant seems to have been cured of HIV.

An unnamed man in London could be the second person in history to be ever cured of HIV infection, offering hope that HIV and AIDS are curable.

FILE PHOTO: Buddhist monks light candles during an HIV/AIDS awareness campaign on the occasion of World AIDS Day in Kolkata, India, December 1, 2018.

"It's one thing when you hear something is manageable and another thing to live it", said Greg Louganis, the Olympic champion diver who was diagnosed with HIV in 1988, six months before he won two gold medals in Seoul.

Since the pandemic began in the 1980s, more than 70 million people have been infected with HIV and about 35 million have died, most in Africa.

"The transplant resulted in the complete destruction of the old immune system and the construction of a new immune system in which the (HIV) virus can't replicate (because of the genetic mutation)".

Sadly, there are some people like Martin Shkreli who seek to profit from the HIV medications. He also received less aggressive conditioning chemotherapy (lomustine, cyclophosphamide, cytarabine and etoposide), alemtuzumab (Campath, a monoclonal antibody that targets CD52 on malignant B and T cells), and cyclosporine-A and methotrexate, immunosuppressive drugs used to prevent graft-versus-host disease (when transplanted immune cells attack the recipient's body).

Timothy Ray Brown, the Berlin Patient, had been living with HIV and routinely using antiretroviral therapy when he was diagnosed with a different disease, acute myeloid leukemia.

Bone marrow transplants are inherently risky and are considered a last resort treatment, so it is unlikely they could be used en masse to treat HIV patients.

This complex treatment involves destroying a person's own immune system with high doses of chemotherapy or radiation.

Such transplants are unsafe, even life-threatening, and have failed in some patients.

This is a hard treatment that carries a high risk of infection and other complications, such as graft-versus-host disease, blood clots and liver disease. Effectively, some scientists believe that the "London patient" has been cured of the viral infection, which affects close to 37 million people worldwide. "But there a small percentage of people who are naturally resistant to HIV infection due to rare genetic mutations known as CCR5-delta 32", he stressed. But that treatment would cover only those types of HIV that rely on the CCR5 surface protein to break into the immune cells. Although it is not a viable large-scale strategy for a cure, it does represent a critical moment in the search for an HIV cure. If researchers can find a way to easily manipulate CCR5, perhaps with CRISPR gene editing, they could open up a path for H.I.V. patients to enter remission without undergoing invasive transplants.

Top panel illustrates the treatment course for the London patient.

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