British man with HIV becomes second person ever to enter remission

BREAKTHROUGH Doctors say they are hopeful the patient is cured

The man is being called "the London patient", because his case is similar to the first known case of a functional cure of HIV - in an American man, Timothy Brown, who became known as the Berlin patient.

Similar therapy has been successful once before with "Berlin Patient", a United States man treated in Germany 12 years ago who is still free of HIV.

The donor - who was unrelated - had a genetic mutation known as "CCR5 delta 32", which confers resistance to HIV.

Now, an worldwide team of scientists led by Ravindra Gupta, a virologist at the University College London, reports a second patient has been in remission for three years following a similar procedure.

A patient may have been cured of his HIV infection, according to a case study to be published Tuesday, marking the second time in the global epidemic's history of long-term remission from the viral disease. CCR5 is known to be a co-receptor for HIV, so mutations in it can help people to become resistant to infection.

The first sustained remission survivor, announced in 2009 as "the Berlin patient" and later named as American Timothy Brown, was given two transplants and underwent total body irradiation to treat leukaemia - a process that almost killed him. About 37 million people worldwide now have HIV, and the AIDS virus has killed about 35 million since taking off in the 1980s.

President Donald Trump extolled the progress made in finding a cure for HIV, as a patient with the virus appears to have been cured by doctors. "This is likely to be many years away and until then, the emphasis needs to remain on prompt diagnosis of HIV and initiation of life-long combination antiretroviral therapy (cART). cART is highly effective both in restoring near normal life expectancy and preventing onward transmission to others".

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But the current news "does teach us a great deal about the HIV virus and how we can possibly create other ways to eradicate it", says Dr. Rosenthal.

In 2016 the patient underwent haematopoietic stem cell transplant and remained on anti-viral drugs for more than a year afterwards.

The first, the Berlin Patient, also received a stem cell transplant from a donor with two CCR5 alleles, but to treat leukaemia. The European group has also been tracking results from 39 HIV-positive blood stem cell transplant patients, 26 of whom are still living.

Most experts say it is unlikely such treatments could be a way of curing all patients.

The ICISTEM group has screened over two million stem cell donors to identify those with the CCR5-delta32 mutation, increasing the chance that new candidate transplant recipients may receive donor cells with this rare genetic mutation. The procedure is expensive, complex and risky. The problems cleared up without intervention, though, and the patient was left with immune cells that lacked the protein used by HIV.

The team is presenting the findings at the annual Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle, US this week. He used antiretroviral drugs for over ten years until he was diagnosed with acute myeloid leukemia.

"I think this does change the game a little bit", Gupta opined to NYT of the new patient, who had less invasive treatment than Brown. The new report shows that doctors don't have to use as intense a treatment regime as the Berlin patient underwent in order to achieve success.

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