Doctors around the world have been trying to find a
HIV or the Human Immunodeficiency Virus causes AIDS or Acquired Immunodeficiency Syndrome when untreated. AIDS is a condition in humans in which progressive failure of the immune system allows life-threatening opportunistic infections and cancers to thrive.
Doctors announced that a second man, who prefers disclosed and to be called the London Patient, is cured and free of the virus after months of being off his antiretroviral pills with no regression.
The news comes nearly 12 years later from the first patient known to have been cured of HIV.
This success confirms that a cure is within reach, difficult but possible. “This will inspire people that cure is not a dream,” said Dr. Annemarie Wensing, a virologist at the University Medical Center Utrecht in the Netherlands. “It’s reachable.”
Timothy Ray Brown, 52, who now lives in Palm Springs, California, the so-called Berlin patient who later went public, made history as the first person ever to be “cured” of HIV. At the time, he had Leukemia, and when chemotherapy didn’t work, he needs two bone marrow transplants.
Like Brown, the London Patient had a Bone Marrow Stem Cell transplant to treat cancer.
Brown and the London Patient both received stem cells from a donor with a rare mutation in the protein called CCR5, which rests on the surface of certain immune cells. HIV uses the protein to enter those cells but cannot latch on to the mutated version, which prevents HIV from thriving.
But, unlike the London Patient, Brown was given harsh immunosuppressive drugs of a kind that is no longer used and suffered sever complications for months after the transplant. He was placed in an induced coma at one point and nearly died.
Once it became clear that Brown was cured, scientists set out to duplicate his result with other cancer patients infected with HIV.
In case after case, the virus came roaring back, often around nine months after the patients stopped taking antiretroviral drugs, or else the patients died of cancer. The failures left scientists wondering whether Mr. Brown’s cure would remain a fluke. Up until the London Patient proved their research was getting somewhere.
In contrast, the London Patient says
He had Hodgkin’s lymphoma and received a bone-marrow transplant from a donor with the CCR5 mutation in May 2016. He, too, received immunosuppressive drugs, but the treatment was much less intense, in line with current standards for transplant patients.
In retrospect, bone marrow transplants are used to treat patients with cancer, not HIV. Transplants are risky and can cause side effects that can last for years.
The medical community don’t see bone marrow transplants as the solution but provides a door towards one. Rearming the body with immune cells similarly modified to resist HIV might well succeed as a practical treatment, experts said.
He quit taking anti-H.I.V. drugs in September 2017, making him the first patient since Mr. Brown to remain virus-free for more than a year after stopping.
“I think this does change the game a little bit,” said Dr. Ravindra Gupta, a virologist at University College London who presented the findings at the Seattle meeting. “Everybody believed after the Berlin patient that you needed to nearly die basically to cure HIV, but now maybe you don’t.”
None of this guarantees that the London patient is forever out of the woods, but the similarities to Mr. Brown’s recovery offer reason for optimism, Dr. Gupta said.
Most people with the HIV-resistant mutation, called delta 32, are of Northern European descent. IciStem maintains a database of about 22,000 such donors.
So far, its scientists are tracking 38 HIV-infected people who have received bone-marrow transplants, including six from donors without the mutation.
The London Patient is 36 on this list. Another one, number 19 on the list and referred to as the “Düsseldorf patient,” has been off anti-HIV drugs for four months. Details of that case will be presented at the Seattle conference later this week.
As of date, nearly 37 million people are affected by HIV. Likewise, 37 million people await the development of this groundbreaking outcome.
Although millions of people diagnosed with HIV are well and can typically live with the average life span by taking a daily pill, this was not the solution to Aids long-term.