London patient might be second to be cured of HIV

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The president of the International Aids Society on Tuesday hailed the news that a second person was reported to be HIV-free, after a stem cell transplant, as a critical moment in the search for an HIV cure for the disease.

The anonymous London man was tested by doctors who said the virus was undetected in the man's system even though he has been off of the antiretroviral therapy for 18 months.

The man is being called "the London patient", because his case is similar to the first known case of a functional cure of HIV - in an American man, Timothy Brown, who became known as the Berlin patient.

Pozniak was commenting in the aftermath of the news that a London patient appears to have been cured of HIV after a bone marrow transplant from a donor with a special genetic mutation. Chemotherapy plus the stem cell transplants were what lead researcher Ravindra Gupta called a "last chance at survival" for the patient.

The subject of the new study has been in remission for 18 months after his antiretroviral therapy (ARV) was discontinued.

"I think this does change the game a little bit", Gupta opined to NYT of the new patient, who had less invasive treatment than Brown.

"Whilst this type of treatment is clearly not practical for millions of people around the world living with HIV, reports such as this may help in the ultimate development of a cure", said Andrew Freedman, a reader in infectious diseases at Cardiff University in Wales.

After being diagnosed with Hodgkin's Lymphoma, a rare blood cancer, the London patient received a bone marrow transplant in 2016.

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The researcher team is due to publish their findings in Nature soon, and give a brief presentation about their work at the Conference on Retroviruses and Opportunistic Infections in Seattle. And we've already identified individuals with cells that can't be infected by HIV (they have a mutation that damages or eliminates a protein that HIV uses to attach to cells), who can act as a source of HIV-resistant cells.

Dr. Gero Hütter, who treated the Berlin patient and is now medical director at Cellex Collection Center in Dresden, Germany, said in an email that the treatment used for the London patient is "comparable" to the one he pioneered.

Specialists said it is also not yet clear whether the CCR5 resistance is the only key - or whether the graft-versus-host disease may have been just as important.

The breakthrough comes ten years after the first such case of a patient with HIV going into sustained remission, known as the 'Berlin Patient'.

The patient remained on ARV for 16 months after the transplant, at which point the clinical team and the patient made a decision to interrupt ARV therapy to test if the patient was truly in HIV-1 remission. "Everybody believed after the Berlin patient that you needed to almost die basically to cure HIV, but now maybe you don't".

Stem cell transplants typically are harsh procedures which start with radiation or chemotherapy to damage the body's existing immune system and make room for a new one. But HIV drugs have become so effective that many people carrying this infection have a normal lifespan if they take these medications for a lifetime.

Dr. Timothy Henrich, an associate professor of medicine and physician scientist at University of California, San Francisco's Department of Medicine, also noted that the London patient's treatment "is not a scalable, safe or economically viable strategy to induce HIV remission".

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