Second patient free of HIV after stem-cell therapy

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A SECOND person has experienced sustained remission from HIV-1 after ceasing treatment, reports a paper led by researchers at UCL and Imperial College London.

The case report, published in Nature and carried out with
partners at the University of Cambridge and the  niversity of Oxford, comes ten years after the first such case, known as the ‘Berlin Patient.’

Both patients were treated with stem cell transplants from donors carrying a genetic mutation that prevents expression of an HIV receptor CCR5.

The subject of the new study has been in remission for 18 months after his antiretroviral therapy (ARV) was discontinued.

The authors say it is too early to say with certainty that he has been cured of HIV, and will continue to monitor his condition. “At the moment the only way to treat HIV is with medications that suppress the virus, which people
need to take for their entire lives, posing a particular challenge in developing countries,” said the study’s lead author, Professor Ravindra Gupta (UCL, UCLH and University of Cambridge).

“Finding a way to eliminate the virus entirely is an urgent global priority, but is particularly difficult because the virus integrates into the white blood cells of its host.” Close to 37 million people are living with HIV worldwide, but only 59% are receiving ARV, and drug-resistant HIV is a growing concern. Almost one million people die annually from HIV related causes.

The report describes a male patient in the UK, who prefers to remain anonymous, and was diagnosed with HIV infection in 2003 and on antiretroviral therapy since 2012.

Later in 2012, he was diagnosed with advanced Hodgkin’s Lymphoma. In addition to chemotherapy, he underwent a haematopoietic stem cell transplant from a donor with two copies of the CCR5Δ32 allele in
2016.

Almost three years after he received bone marrow stem cells from a donor with a rare genetic mutation that resists HIV infection – and more than 18 months after he came off antiretroviral drugs – highly sensitive tests still show no trace of the man’s previous HIV infection.