Stem cell patient 'cured' of HIV

Nora Nguyen
March 9, 2019

He had developed cancer and received a bone marrow transplant with stem cells that ultimately proved resistant to HIV.

According to the report, the patient was diagnosed with HIV in 2003 and was on anti-HIV drugs since 2012.

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. Until now, success in replicating that cure has been limited.

PhD student works with HIV virus in the Biosafety Level 3 lab of the Institute of Biomedical Research in Retroviruses and AIDS (INBIRS). "It's important because there are 36 million-odd people with HIV worldwide". Of these, about 1.1 million live in the U.S. His HIV has never returned. The field was revolutionized in 1996 with the introduction of HIV anti-retroviral therapy medications.

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"In the second theory, you are mixing two immune systems, with your new immune system reacting against your original one", Lewin said. "And for people at risk for HIV there are medications they can take that will keep them HIV free".

"We now have tremendous treatments that are easy to take, with low side effects", Baeten said.

"What this second case says is this is a bonafide research target and probably the most promising we have for any HIV cure", he said.

This is a hard treatment that carries a high risk of infection and other complications, such as graft-versus-host disease, blood clots and liver disease.

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In 2012, he contracted a leg infection that required him to have his right leg amputated below the knee. He is survived by his third wife, Patricia Ann Christ, and a daughter from his first marriage.

Compared to Brown, the London patient had a less punishing form of chemotherapy to get ready for the transplant, didn't have radiation and had only a mild reaction to the transplant. In the 1% north Europeans who inherit the mutation from each parent, it offers immunity against infection.

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

The patient remained on ARV for 16 months after the transplant, at which point the clinical team and the patient chose to interrupt ARV therapy to test if the patient was truly in HIV-1 remission.

Replacing the immune cells with those that do not have the CCR5 receptor appears to help prevent HIV from rebounding after the treatment.

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Top panel illustrates the treatment course for the London patient. Otwoma said although there has been a notable decline in new HIV infections, continued effort is still needed to develop an efficacious, accessible and affordable HIV vaccine. One of them is former San Francisco Supervisor Jeff Sheehy, who was diagnosed 22 years ago, when people were still dying from AIDS.

The researchers picked a donor who had two copies of a mutation in the CCR5 gene, which gives people resistance to HIV infection.

"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 said. Neither should anyone else.

All three cases have involved patients receiving cancer treatment separate to their HIV diagnosis. This week Brown celebrated 12 years free of HIV and was at CROI to hear about the "London patient".

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"All HIV cure approaches in general are in their infancy", he said in a telephone interview.

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