More than a decade later, a second case of permanent remission of HIV after a stem cell transplant has just been announced.

Remember this nickname "the London patient", because you could be remembered as the second person to be "cured" of HIV. This is a Londoner who prefers to remain anonymous, but who has been in remission of HIV for a year and a half after a bone marrow transplant. More than a decade later, we now know that Timothy Brown, "the Berlin patient," was not an anecdote.

Actually, the case just published in Nature (and being presented today at the Seattle Conference on Retroviruses and Opportunistic Infections) is "too premature" to declare itself officially cured, but the results are so good that experts are already talking of healing without hindrance.

Beyond the anecdote

The London Patient The patient, as explained in Nature, was diagnosed in 2003 and had been on antiretroviral therapy since 2012. That same year, he was diagnosed with advanced Hodgkin lymphoma, a cancer with a poor prognosis.

What happened? As in the other cure case, that of Timothy Brown (“the patient from Berlin”) 12 years ago, the remission of HIV is related to a bone marrow transplant whose objective was to treat the cancer that he suffered from. Although this year the treatment with chemotherapy has been less intensive.

In 2016, he underwent a hematopoietic stem cell transplant from a donor with two copies of the CCR5 gene, a mutation that only has 1% of the population and provides resistance to the virus. The same mutation we talked about in the case of Chinese girls edited with CRISPR. During these years we have seen other cases, but none so similar to the Berlin case.

No sign of HIV After the transplant, the "London patient" remained on antiretroviral therapy for 16 months and since September 2017, without medication, regular tests have not been able to detect viral load in the patient.

"By achieving remission in a second patient using a similar method, we demonstrated that 'the Berlin patient' was not an abnormality," explained Ravindra Gupta, a professor at the University of Cambridge and the lead author of the research.

Have we found the cure for HIV? No no and no. I think that many times I write 'no' I will be unable to convey how far we are from achieving a clinically viable cure for HIV. Bone marrow transplantation is not only a dangerous and extremely painful procedure, but the two patients suffered serious disorders after the intervention (the patient's cells attacked those of the donor).

In other words, we are not facing a generalizable treatment for HIV. That does not mean it is not important. Now, with this confirmation on the table, the researchers know that it is not an anecdote: we are facing what is perhaps one of the most interesting lines of research of the moment.

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