A HIV positive man has become the second person to go into sustained remission from the virus and cleared of AIDS after receiving a bone-marrow transplant.
The case is the second ever observed of sustained HIV remission according to a UK study, although the authors say it’s too early to confirm whether the patient is indeed “cured” of the virus which causes AIDS. The man, known as the “London Patient”, has been in remission for 19 months.
Another patient, Timothy Brown, known as the “Berlin Man” was sent into remission 10 years ago by a similar treatment, but attempts to replicate the result have failed until now.
UNAIDS speaks out
UNAIDS said in statement on Tuesday that it is greatly encouraged by the news that an HIV-positive man has been functionally cured of HIV.
The man was treated by specialists at University College London and Imperial College London for advanced Hodgkin’s lymphoma in 2016 using stem cell transplants from a donor who carried a rare genetic mutation. Researchers report that HIV has been undetectable in the man since he stopped taking antiretroviral medicine 18 months ago.
“To find a cure for HIV is the ultimate dream,” said Michel Sidibé, Executive Director of UNAIDS. “Although this breakthrough is complicated and much more work is needed, it gives us great hope for the future that we could potentially end AIDS with science, through a vaccine or a cure. However, it also shows how far away we are from that point and of the absolute importance of continuing to focus HIV prevention and treatment efforts.”
Stem cell transplants are highly complex, intensive and costly procedures with substantial side-effects and are not a viable way of treating large numbers of people living with HIV. However, the results do offer a greater insight for researchers working on HIV cure strategies and highlight the continuing importance of investing in scientific research and innovation.
The result, reported at the Conference on Retroviruses and Opportunistic Infections in Seattle, United States of America, is one of only two cases of reported functional cures for HIV. The first was the case of the Berlin patient, Timothy Ray Brown, who received similar treatment for cancer in 2007.
There is currently no cure for HIV. UNAIDS is working to ensure that all people living with and affected by HIV have access to life-saving HIV prevention, treatment, care and support services.
In 2017, there were 36.9 million people living with HIV and 1.8 million people became newly infected with the virus. In the same year, almost 1 million people died of AIDS-related illnesses and 21.7 million people had access to treatment.
‘WE NEED TO BE CAUTIOUS’
“This is a very interesting and encouraging result; however we need to be cautious for a number of reasons,” UNSW’s Kirby Institute director Professor Anthony Kelleher said.
“Firstly, the bone marrow transplant in both HIV cure cases were primarily used to treat cancers of the blood and were modified to enable a HIV cure. So, the cost benefit of the prognosis following a bone-marrow transplant versus that on HIV antiretroviral therapy needs serious consideration.
“Secondly, naturally resistant and compatible bone marrow donors are rare because of the need for donor recipient matching. Further, this type of procedure is not widely available in many countries.
“Finally, there is significant morbidity and mortality associated with this type of transplantation, even when conducted in the best centres, and under the best circumstances.
“While there are important limitations to applying this study to a HIV cure globally, this second documented case does reinforce the message that HIV cures are possible.
“Common to both approaches is the presence of a modified gene in our immune system (CCR5) that is necessary for HIV infection.
“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.
“However, there are still significant hurdles in this field as well.”
The CCR5 gene is also associated with controversial “gene editing” by Chinese scientist He Jiankui last year, that led to the birth of the world’s first gene-edited twin babies.