Breakthrough: A Second HIV Patient Has Gone Into 'Long-Term' Remission

Nearly three years after he received bone marrow stem cells from a donor with a rare genetic mutation that resists HIV infection - and more than 18 months after he came off antiretroviral drugs - highly sensitive tests still show no trace of the man's previous HIV infection.

The breakthrough comes ten years after the first such case of a patient with HIV going into sustained remission, known as the 'Berlin Patient'. He described his patient as "functionally cured" and "in remission", but cautioned: "It's too early to say he's cured".

Although Brown almost died after he was given strong immunosuppressive drugs and was put into a coma, the "London patient" did not come that close; he suffered from Hodgkin's lymphoma and received a similar bone-marrow transplant to Brown's, but the immunosuppressive drugs he received were gentler. 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.

The man, known as the "London patient" was being treated for advanced Hodgkin's lymphoma-a type of cancer that affects the blood.

The second person, dubbed "The London Patient", was treated by specialists at the University College London and Imperial College in 2016 and has shown no sign of the virus since. This mutation of the CCR5 gene makes the people who carry it resistant to HIV. The team also found that his white blood cells now can not be infected with CCR5-dependent HIV strains, indicating the donor's cells had engrafted. The study will also be presented at an HIV conference in Seattle. About 37 million people around the world have the viral infection.

Doctors said that recent tests showed no trace of the man's previous HIV infection.

Graphic on how HIV attacks white blood cells
Graphic on how HIV attacks white blood cells

In a statement to The Times, the London patient said it was "surreal" to think that he could be cured of both cancer and HIV.

"The so-called London Patient has now been off ART for 19 months with no viral rebound which is impressive, but I would still be closely monitoring his viral load", IAS Governing Council Member and co-chair of it cure initiative, Sharon Lewin, said. The first, Timothy Ray Brown-previously known as the "Berlin Patient"-received a similar but more aggressive form of treatment for his leukemia".

But rearming the body with immune cells similarly modified to resist HIV might well succeed as a practical treatment, experts said.

The important point here is that it had been assumed that there might be something special about the Berlin patient, but now "we know it is reproducible", said Hütter, who was not involved in the London patient's treatment. Brown is thus far the only adult who has been cured of HIV. "The hope is that this will eventually lead to a safe, cost-effective and easy strategy.using gene technology or antibody techniques". The patient, who chose to be anonymous, was cured after a stem cell transplant.

Although a bone-marrow transplant cannot be a standard treatment for HIV, doctors can use what they learn in these special cases to try to develop new treatments that could be used by more people, Adalja said.

Brown hopes that the "London patient" will survive as long as he has.

  • Santos West