Published: Sun, March 10, 2019
Medical | By Vicki Mclaughlin

The London Patient and an HIV ‘Cure’: What You Need to Know

The London Patient and an HIV ‘Cure’: What You Need to Know

Biopsies from his gut and lymph nodes have shown no infectious HIV following a bone marrow transplant, and three-and-a-half months off antiviral drugs, Annemarie Wensing of the Netherlands-based University Medical Center Utrecht, who worked on the case, told the outlet.

The doctors stressed the need for proper guidelines around the new treatment, which, if proved successful in more cases, could change lives of millions of people. Timothy Brown was given two transplants and total body irradiation for leukaemia, and is said to be the first person to beat Aids/HIV.

He had received bone marrow from a donor with a mutated gene for the CCR5 protein, which is found on white blood cells.

Similarly, access to two prevention interventions called PEP, or post-exposure prophylaxis, where patients take a one month course of the HIV cocktail after possible exposure to HIV, and PrEP, or pre-exposure prophylaxis, where patients at risk of contracting HIV take one daily pill of the HIV-treatment drug Truvada, are extremely effective at preventing new infections among those most at risk. At the time, many in the field of HIV research were excited to learn that this man, who tested positive for the human immunodeficiency virus in Berlin and had recently undergone treatment for acute myeloid leukemia, appeared to have been cured of his HIV.

Other HIV patients from IciStem have also undergone similar bone marrow transplants for cancer, but they have not yet stopped taking the antiviral medications at this point.

Around 22,000 people are known have the CCR5 mutation, and they are mostly northern European.

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The transplant involves killing nearly all the immune cells and replacing them with donor cells, and is so risky it can only be carried out on people with cancer.

Researchers learned that Brown and the "London patient" both shared a novel treatment course. When HIV-infected individuals are compliant with the prescribed use of the AIDS cocktail, their viral load is undetectable and they become untransmittable, meaning they can not sexually transmit the HIV virus to others.

So no, the news of the London patient's HIV remission may not represent a true cure for HIV yet, but it likely does inch us one step closer to that all-important goal. When the patient received the donor transplants with this specific genetic mutation it also made him resistant to HIV as well.

Top panel illustrates the treatment course for the London patient. Add to this that only about one percent of Caucasians are CCR5 negative-this being a mutation that only appears in European bloodlines-and it quickly becomes apparent that we can not feasibly use stem cell transplants to make every person with HIV enter remission.

However, it's not just surviving the transplant that confers the HIV "cure" or remission.

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