A London man has become the second in the world to be ‘cured’ of HIV after a bone marrow transplant from an HIV resistant donor, doctors said.
The discovery could pave the way for a way to end AIDS, but it does not yet mean that a usable cure for HIV has been found, doctors cautioned.
The patient is still testing negative for HIV, three years after receiving bone marrow stem cells from a donor with a rare genetic mutation that resists HIV infection.
He has also not taken antiretroviral drugs for 18 months.
The new case comes 10 years after the first patient was ‘cured’ of HIV, known as the ‘Berlin patient’, using a similar method.
‘There is no virus there that we can measure. We can’t detect anything,’ said Ravindra Gupta, a professor and HIV biologist.
‘By achieving remission in a second patient using a similar approach, we have shown that the Berlin Patient was not an anomaly and that it really was the treatment approaches that eliminated HIV in these two people.’
Gupta described his patient as ‘functionally cured’ and ‘in remission’, but cautioned: ‘It’s too early to say he’s cured.’
The man is being called ‘the London patient’, in part because his case is similar to the first known case of a functional cure of HIV – in an American man, Timothy Brown, who became known as the Berlin patient when he underwent similar treatment in Germany in 2007 which also cleared his HIV.
Brown, who had been living in Berlin, has since moved to the United States and, according to HIV experts, is still HIV-free.
The AIDS pandemic has killed around 35 million people worldwide since it began in the 1980s.
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Scientific research into the complex virus has in recent years led to the development of drug combinations that can keep it at bay in most patients.
Gupta, now at Cambridge University, treated the London patient when he was working at University College London. The man had contracted HIV in 2003, Gupta said, and in 2012 was also diagnosed with a type of blood cancer called Hodgkin’s Lymphoma.
In 2016, when he was very sick with cancer, doctors decided to seek a transplant match for him. ‘This was really his last chance of survival,’ Gupta said.
The donor – who was unrelated – had a genetic mutation known as ‘CCR5 delta 32’, which confers resistance to HIV.
The transplant went relatively smoothly, Gupta said, but there were some side effects, including the patient suffering a period of ‘graft-versus-host’ disease – a condition in which donor immune cells attack the recipient’s immune cells.
Most experts say it is inconceivable such treatments could be a way of curing all patients. The procedure is expensive, complex and risky.
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.
Both the Berlin and London patients had this complication, which may have played a role in the loss of HIV-infected cells, Gupta said.