'London patient': second case ever of HIV remission

London HIV Patient Becomes World's Second Man To Be Cured Of AIDS Virus

Both patients had received bone marrow transplants to treat blood cancers, receiving stem cells from donors with a rare genetic mutation that prevents HIV from taking hold.

The first case was reported in 2007 when a HIV-positive American citizen, identified as Timothy Brown, who had undergone a similar treatment later tested HIV-negative.

The breakthrough has come via bone marrow transplants that were meant to cure cancer in the patients, not the HIV virus.

Ten years ago, another patient in Berlin received a bone marrow transplant from a donor with natural immunity to the virus. Highly sensitive tests showed no trace of the man's previous HIV infection.

The new case report comes more than 10 years after the first case, known as the "Berlin patient".

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Gupta, now at Cambridge University, treated the London patient when he was working at University College London. "But we can try to tease out which part of the transplant might have made a difference here, and allowed this man to stop his anti-viral drugs". Brown, who required two transplants to cure his leukemia, had intensive chemical treatment and, on top of that, received whole body irradiation.

"Even if we're not going to cure the world with stem cell transplants", Johnston says, "it's important to have a collection of people who've been cured so we can put together that information to figure out how we can do a cure more broadly".

The transplant went relatively smoothly, Gupta said, but there were some side effects, including the patient suffering a period of "graft-versus-host" disease - a condition in which donor immune cells attack the recipient's immune cells. "Those of us in the field have been waiting for a second cure via this approach", said Dr. Keith Jerome, one of the leaders of HIV cure research at the Fred Hutchinson Cancer Research Center.

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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.

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After two bone marrow transplants, Brown was considered cured of his HIV-1 infection. The London patient is one of 40 in the study. It's far from a cure, but Tebas thinks coupling this approach with other interventions "might be the way of the future". Another one, number 19 on the list and referred to as the "Düsseldorf patient", has been off anti-HIV drugs for four months.

The research team is presenting the findings at the annual Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle, Washington. "Some of them are directly related to the Berlin patient and work with transplantation: for example, gene modification therapy".

Most experts who know the details agree that the new case seems like a legitimate cure, but some are uncertain of its relevance for AIDS treatment overall.

Scientists are also examining immune modifying therapies.

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