Sunday, 26 May, 2019

A third person may have been ‘cured’ of HIV

Credits NIH Credits NIH
Anna Jefferson | 10 March, 2019, 18:21

And the virus keeps surprising researchers, so it's best to keep up the fight on all fronts.

It came hours after researchers reported a "London patient" was the second ever man to see the disease "cured" by a bone marrow transplant - which effectively replaces and reboots the cells of the immune system where HIV persists.

Researchers say a man appears to be free of the AIDS virus after a stem cell transplant.

Scientists are hailing this as a triumph that may very well lead to a mainstream cure down the line, but they caution that this exact treatment is unlikely to have widespread applications.

According to the United Nations, there are an estimated 37 million people worldwide living with HIV. Having replicated the original success, however, experts are calling this a "proof of concept" that medicine can rid the body of HIV. The first was the case of the Berlin patient, Timothy Ray Brown, who received similar treatment for cancer in 2007. The drugs can also have serious negative side effects.

Around 22,000 people are known have the CCR5 mutation, and they are mostly northern European. He became ill with blood cancer, against which he had a transplant with marrow from a donor with a mutation in the gene CCR5 that made him resistant to the virus. The mutation changes this receptor in such a way that it blocks HIV. But there's an ever-present danger of raising false hopes for millions of people living with HIV, because the stem cell transplant is neither practical nor safe enough to use on anyone who has just HIV and not an otherwise fatal cancer. Additional follow-up research must be done to insure that the new bone marrow produced reconstitutes the patient's immune system with the CCR5 genetic mutation so that HIV treatment can be stopped.

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However, there are also growing concerns regarding current treatments.

Graphic on how HIV attacks white blood cells. It could be a combination of the three or another unknown cause. The doctors were hopeful that their less intense treatment worked and announced a cure-prematurely. Unfortunately, both men relapsed. Cells without a working CCR5 receptor are essentially locked up to the virus.

Most importantly, the HIV community learned that Brown's case was not unique. He was later diagnosed with advanced Hodgkin's lymphoma, cancer of the immune system. Instead of having to do not forget to take pills, patients instead could get injections from a doctor or nurse each month.

Government Chief Medical Officer, Prof Mohammad Kambi, said yesterday in Dar es Salaam that the development was a new milestone achievement but should not make people relax and stop taking all necessary preventive measures against the disease because no cure has been found yet. "It's reachable." It is also initial evidence that a less rigorous version of the treatment could exist.

"This is a very encouraging piece of news, it's an encouraging step". This may lead to additional medication (there is already a drug that can mimic the mutation if taken daily), gene therapies, or vaccines that also target the receptor. The treatment is simply too harsh, and the risks are too great. HIV has become a chronic condition in which progression to AIDS is increasingly rare. When an HIV positive patient achieves viral suppression and has an undetectable viral load, not only does s/he have a significantly increased likelihood of improved health outcomes, but it also eliminates their likelihood of transmitting HIV.

The next big question is how the knowledge gained from CCR5 stem cell transplants might actually help create a true cure for HIV.

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