Second Man Is HIV-Free After Stem Cell Transplant

Hope as man 'free of HIV virus' after treatment - report

He also received less aggressive conditioning chemotherapy (lomustine, cyclophosphamide, cytarabine and etoposide), alemtuzumab (Campath, a monoclonal antibody that targets CD52 on malignant B and T cells), and cyclosporine-A and methotrexate, immunosuppressive drugs used to prevent graft-versus-host disease (when transplanted immune cells attack the recipient's body).

Get push notifications with news, features and more. "At the moment the procedure still carries too much risk to be used in patients who are otherwise well, as daily tablet treatment for HIV is able to usually able to maintain patient's long-term health".

Adalja noted that although the Berlin patient and the London patient received similar treatments, the Berlin patient's treatment was more intense - he received two bone-marrow transplants in addition to whole-body irradiation (radiation exposure to the whole body).

In Berlin in 2007, Brown, an HIV-positive man with acute myeloid leukaemia, received a bone marrow transplant from a donor who was naturally resistant to HIV infection because of a mutation in the CCR5 gene, a critical protein required by HIV to enter and infect cells. Her group has been working on a way to mutate the CCR5 gene directly in the bone marrow of a person to simulate the effect of the transplants.

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A digitally colorized scanning electron microscopic (SEM) image depicts a single, red colored H9-T cell that had been infected by numerous, spheroid shaped, mustard colored human immunodeficiency virus (HIV) particles attached to the cell's surface membrane, as seen in this 2012 image obtained from the National Institute of Allergy and Infectious Diseases (NIAID) located in Bethesda, Maryland, U.S., on March 5, 2019. Other attempts had failed.

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 maybe that's what's happening here - the graft is eliminating any residual HIV", Lewin said. Rather than do whole-body radiation to kill the patient's existing immune cells, the patient was given chemotherapy and drugs that specifically targeted his immune cells prior to the transplant.

The Trump administration plans to eliminate the virus once and for all with the expansion of four key strategies-diagnose, treat, protect, and respond-that will be implemented across the nation within the next 10 years, according to a blueprint (pdf) of the proposal released by HHS. They made a decision to stop treating him with antiviral drugs after he volunteered to stop taking them.

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"It's not a cure yet, but 18 months is a fairly long time without a rebound", Kiem said.

"This is a highly significant study", said Aine McKnight, a professor of viral pathology at Queen Mary University of London in a statement.

But McKnight cautioned that this won't necessarily lead to a treatment for all HIV individuals. A second, less common form of HIV, could still cause infection despite a transplant like this.

These circumstances are closely paralleled by the newly reported patient. This experiment raised an ethical furor. For now, its use is restricted to those who need the transplant for other reasons, not for HIV alone, said Henrich, who was not involved in the new case study. "After 2 years, we'll be talking more about 'cure, '" Gupta says. And now, a year and a half after he last took antiretroviral medications, the London patient is no longer showing signs of the virus.

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The so-called "London patient", who remains anonymous, underwent stem cell transplantation to treat Hodgkin lymphoma in May 2016. About 1 percent of people descended from northern Europeans have inherited the mutation from both parents and are immune to most HIV.

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