2nd HIV patient in 'sustained remission,' physicians say

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Scientists have just reported a new case study of a previously HIV+ man, referred to as the "London Patient", who has no remaining detectable HIV a year and a half after undergoing a bone marrow stem cell transplant to treat lymphoma.

Both the London and Berlin patients received stem cell transplants from donors carrying a genetic mutation that prevents expression of an HIV receptor, known as CCR5.

In the only other known case, Timothy Ray Brown of the USA became HIV-free after a stem cell transplant in Germany 12 years ago and is still free of the virus.

For only the second time, doctors have announced they have "effectively cured" a patient with HIV using stem cells, sending the virus into "sustained remission".

Researchers from University College London, Imperial College London, Cambridge and Oxford Universities were all involved in the case. Specifically, the donor had two copies of a version of the CCR5 gene.

Nearly 1 million people die each year from HIV-related causes and the only current treatment available is for the affected to take antiretroviral drugs for their entire lives.

For this reason, he's often described as being the first patient "cured" of HIV, although technically that's incorrect, since remission and cures are not the same thing (as sometimes remissions are not complete, if the viral load stages a resurgence).

According to Reuters, experts say that it may not be possible to widely adopt the procedure given its complexity and the difficulty of finding donor matches who have the HIV-resistant genetic mutation.

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Although the treatments that the two men received can only be used in a tiny proportion of the 37 million people infected with HIV globally, the outcomes point to cure strategies that could be applied more broadly. His drug regiment was much less harsh than the only other known patient who was cured of HIV. Because of these risks, stem cell transplants haven't been considered a treatment option for HIV patients. There are now 37 million people infected with HIV, 21 million are on antiretroviral treatment, but drug-resistant strains are becoming more widespread. At its outset, HIV infection looks and feels a lot like the flu.

As part of his cancer treatment and transplant, the London patient received a malfunctioning CCR5 gene, which creates a protein crucial for HIV to invade blood cells, researchers said.

Experts say the approach is not practical for treating most people with HIV but may one day help find a cure.

"There is no virus there that we can measure". He has been in remission ever since and is said to be the first person in the world to have been cured of HIV. Finding ways to treat people infected with HIV with some infusions of mutated CCR5 cells that block infection seems to make more sense now.

"With regular testing, condoms, pre-exposure prophylaxis (PrEP) and the fact that people on effective HIV treatment can not pass on the virus, we have the ability to completely prevent new HIV transmissions".

The case was published online by the journal Nature and will be presented at an HIV conference in Seattle.

In the meantime, he said the focus needed to be on diagnosing HIV promptly and starting patients on lifelong combination antiretroviral therapy. Unlike Brown, though, the London patient did not have to go through a horrific, near-death experience to reap the benefits of the therapy.

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