Sunday, 26 May, 2019

Second man seems to be free of AIDS virus after transplant

Timothy Ray Brown Timothy Ray Brown
Anna Jefferson | 05 March, 2019, 09:21

The case is a proof of the concept that scientists will one day be able to end AIDS, the doctors said, but does not mean a cure for HIV has been found.

A London man appears to be free of the AIDS virus after a stem cell transplant - marking a potential milestone breakthrough, 12 years after the first success.

Timothy Ray Brown, aka the "Berlin patient," the only person to be cured of HIV, may finally have company.

Millions of people infected with HIV around the world keep the disease in check with so-called antiretroviral therapy (ARV), but the treatment does not rid patients of the virus.

"This tells us that the feasibility, and importantly, the availability of delivering this approach could possibly be achieved by the rapidly accelerating field of gene editing and related gene therapies".

"This poses a particular challenge in developing countries", where millions are still not receiving adequate treatment, he added.

Nonetheless, future research into how this HIV receptor functions could bring us a lot closer to an eventual cure for HIV, which now infects around 37 million people worldwide.

In some of the past transplant failures, the donor did not have a mutated CCR5, but the conditioning regimen seemed to have significantly reduced the "reservoirs" of cells in the recipient that have latent HIV infections, invisible to the immune system. Nearly three years after receiving bone marrow stem cells from a donor with a rare genetic mutation that resists HIV infection - and more than 18 months after coming off antiretroviral drugs - highly sensitive tests still show no trace of the man's previous HIV infection'.

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But a second case of remission and likely cure following such a transplant will help scientists narrow the range of treatment strategies, he and others said.

Doctors found a donor with a gene-mutation that is naturally resistant to the HIV virus, according to the findings.

"Finding a way to eliminate the virus entirely is an urgent global priority, but is particularly hard because the virus integrates into the white blood cells of its host", Gupta explained. The London patient, who had Hodgkin's lymphoma, is the first adult to be cleared of HIV since Brown. The donor had this double copy of the mutation.

CCR5 is the most commonly used receptor by HIV-1. To do this in others, exact match donors would have to be found in the tiny proportion of people - majority of northern European descent - who have the CCR5 mutation that makes them resistant to the virus.

But rearming the body with immune cells similarly modified to resist HIV might well succeed as a practical treatment, experts said.

Almost three years after receiving bone marrow stem cells, and more than 18 months after coming off antiretroviral drugs - highly sensitive tests still show no trace of the man's previous HIV infection. After two bone marrow transplants, Brown was considered cured of his HIV-1 infection.

Sharon Lewin, an expert at Australia's Doherty Institute and co-chair of the International AIDS Society's cure research advisory board, told Reuters news agency the London case points to new avenues for study.

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