Medicine

Second Patient Achieves Sustained HIV-1 Remission After Treatment Cessation

Second Patient Achieves Sustained HIV-1 Remission After Treatment Cessation

The milestone came about three years after the man received bone marrow stem cells from an HIV-resistant donor and about a year and a half after coming off antiretroviral drugs.

Researchers in London say that an HIV patient has been cleared of the virus after receiving a bone marrow transplant.

Achieving remission in a second patient with HIV using similar methods demonstrated that the first occurrence was not anomalous.

The therapy works by effectively replacing the blood cells of an infected person with that of someone who is immune to HIV through a genetic mutation which prevents to virus attaching to cells.

But a second instance of remission and likely cure following such a transplant will help scientists narrow the range of treatment strategies, he and others said. "We can't detect anything", said Ravindra Gupta, a professor and HIV biologist who co-led a team of doctors treating the man.

"Finding a way to eliminate the virus entirely is an urgent global priority, but is particularly hard because the virus integrates into the white blood cells of its host". The circumstances in both cases indicate that people with HIV who have a cancer, and who need a stem cell transplant to treat it, may be cure candidates. But HIV drugs have become so effective that many people carrying this infection have a normal lifespan if they take these medications for a lifetime.

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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.

That means the London patient may have HIV remaining that can use CXCR4 to infect cells, giving the virus a way to start flourishing again. About 1 percent of people descended from northern Europeans have inherited the mutation from both parents and are immune to most HIV. People who have two mutated copies of the CCR5 allele are resistant to the HIV-1 virus strain that uses this receptor, as the virus can not enter host cells.

But it in the past 18 months he was taken off the extra drugs and regular testing confirmed his viral load is now undetectable.

There may be real hope for sufferers with AIDS; after twelve years, a second person has apparently been cured of H.I.V., the virus that precedes AIDS. The American was afflicted with acute myeloid leukemia and received a stem cell transplant from a donor with the same CCR5 delta 32 gene.

The scientists involved in the study are set to publish their report today in the journal Nature.

The research was funded by Wellcome, the Medical Research Council, the Foundation for AIDS Research, and National Institute for Health Research (NIHR) Biomedical Research Centres at University College London Hospitals, Oxford, Cambridge and Imperial. They also plan to present details in Seattle at the Conference on Retroviruses and Opportunistic Infections, which began Monday.

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