Nearly 12 years after the first patient known to be cured of infection with HIV, another patient has been declared ‘virus-free’. For just the second time since the global epidemic began, a patient treated with bone-marrow transplant has ended up in remission from HIV.
The London patient was being treated for Hodgkin’s cancer. He underwent chemotherapy and in addition, stem cells were implanted into the patient from a donor resistant to HIV. This has lead to both his cancer and HIV going into remission.
He was diagnosed with HIV in 2003 and advanced Hodgkin’s lymphoma in 2012.
The patient has now been in remission from HIV for 18 months and is no longer taking HIV drugs. Meanwhile, the researchers say it is too early to say the patient is “cured” of HIV.
This is a feat that researchers have long tried and failed, to duplicate. Experts say the approach is not practical for treating most people with HIV but may one day help find a cure.
Published in the journal Nature, this new breakthrough is to be presented at the Conference on Retroviruses and Opportunistic Infections in Seattle. Researchers from University College London, Imperial College London, Cambridge and Oxford Universities were all involved in the case.
Another patient from Berlin was the first recorded case of HIV remission after receiving a bone-marrow transplant from a donor with natural immunity to the virus.
The CCR5 receptor gene is most commonly used by HIV-1 – the virus strain of HIV that dominates around the world. However, a minuscule number of people resistant to HIV have two mutated copies of the CCR5 receptor. This implies that the virus cannot penetrate cells in the body that it normally infects and multiply.
However, the reservoir of cells carrying HIV can also remain in the body, in a resting state, for many years. This area is yet to be explored as only two successful cases of remission has been registered till now and in both cases, the patients were also diagnosed with variants of cancer.
Researchers say it is difficult, not impossible, to use gene therapy to target and shut down the CCR5 receptor in people with HIV, now they know the Berlin patient’s recovery was not a one-off.
Meantime, in a country like India, where the patients with HIV infection are outcast due to societal stigma, researchers say the focus should remain on diagnosing HIV promptly and starting patients on lifelong combination antiretroviral therapy (cART). This can prevent the virus from being transmitted to others and give people with HIV a near-normal life expectancy.