Long-Term HIV Remission After Medicine Discontinued

Alicia Farmer
March 8, 2019

The new case, the "London patient", was diagnosed with HIV in 2003, and put on antiretrovirals in 2012. The milestone came about three years after the man received bone marrow stem cells from an HIV-resistant donor and about a year and a half after coming off antiretroviral drugs.

"It is a landmark".

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

A patient diagnosed with HIV and treated with stem cell transplant has been in remission for 18 months after his antiretroviral therapy (ARV) was discontinued, according to a press release Tuesday posted on the website of the University of Cambridge.

"While this type of treatment is clearly not practical to treat the millions of people around the world living with HIV, reports such as these may help in the ultimate development of a cure for HIV". Almost 37 million people have been infected world-wide over the past four 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".

Timothy Brown, said to be the first person to "beat" HIV/Aids, was given two transplants and total body irradiation (radiotherapy) for leukaemia - a much more aggressive treatment.

Although the treatments that the two men received can only be used in a tiny proportion of the 37 million people infected with HIV globally, the outcomes point to cure strategies that could be applied more broadly. "Radiation has a lot of side-effects and leads to a delayed recovery of the bone marrow, so it's really good that we've shown you don't need radiation".

The London patient, who is remaining anonymous, also underwent chemotherapy.

The male patient has achieved "sustained remission" from HIV after being treated at Hammersmith Hospital in west London, Imperial College Healthcare NHS Trust said.

Vial of blood

Along with a shared HIV diagnosis, both patients had a form of blood cancer that did not respond to chemotherapy.

"There is no virus there that we can measure".

Nevertheless, Gupta hopes the work demonstrates the viability of other, less risky, CCR5 modifications, possibly through gene therapy. But with the mutated CCR5, Brown's immune cells became molecular fortresses that HIV couldn't penetrate - which meant the transplant essentially cured him of his infection.

"This is a big deal", says Sharon Lewin, who heads the Peter Doherty Institute for Infection and Immunity in Melbourne, Australia.

As part of his cancer treatment and transplant, the London patient received a malfunctioning CCR5 gene, which creates a protein crucial for HIV to invade blood cells, researchers said.

Regular testing has confirmed that the patient's viral load remained undetectable since then.

But scientists were keen to stress that the technique is likely only viable among a tiny percentage of sufferers.

Brown told the Associated Press on Monday that he would encourage the London patient to go public because "it's been very useful for science and for giving hope to HIV-positive people, to people living with HIV".

Specialists said it is also not yet clear whether the CCR5 resistance is the only key - or whether the graft-versus-host disease may have been just as important.

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