This is encouraging news for all people affected by the AIDS virus. A hiv-sized hiv patient who has received a stem cell transplant is now “cured,” making him the second hiv patient in the world to recover from the disease, doctors announced on Tuesday (March 10th). Nearly ten years after the first confirmed case of an HIV patient who had gotten rid of it, this second case, known as “the London patient”, has shown no signs of the virus for 30 months despite discontinuing antiretroviral treatment, according to published in the journal The Lancet HIV.
In March 2019, Professor Ravindra Gupta of the University of Cambridge announced that the man diagnosed with HIV in 2003 was in remission, having shown no signs of the virus in 18 months. The doctor, however, called for caution, insisting on the term remission and not healing, requiring more time.
A year later, his team took that step. “We suggest that our results represent a cure for HIV,” they write, after testing samples of blood, tissue and semen.
‘There will probably be more’
“We have tested a fairly considerable number of places where the virus likes to hide and virtually everything was negative”, except for a few “fossil” remains of non-active viruses, Professor Gupta told AFP. “It’s hard to imagine that any trace of a virus that infects billions of cells has been eliminated,” he said.
Like the “Berlin patient”, the American Timothy Ray Brown considered cured in 2011, this “London patient” underwent a bone marrow transplant to treat blood cancer, and thus received stem cells from donors carrying a rare genetic mutation prevents HIV from entering, CCR5. The fact that the Berlin patient’s recovery remained isolated for almost a decade suggested to some that it was just a stroke of luck.
“Our findings show that the success of stem cell transplantation as an HIV treatment, first reported 9 years ago for the Berlin patient, can be replicated,” say the researchers, who now hope for further success. . Other patients have received similar treatment, but none are as far in remission (…). There will probably be more, but it will take time,” commented Ravindra Gupta.
A very risky stem cell transplant
Meanwhile, the London patient decided to reveal his identity this week in an interview with The New York Times. “I want to be an ambassador of hope,” said Adam Castillejo, 40, who grew up in Caracas, Venezuela. But researchers acknowledge that for now their method is not a solution for the millions of people living with the disease worldwide and control it through antiretrovirals to be taken for life.
The procedure used for the two cured patients is very cumbersome and risky, asking “ethical” questions, stresses Professor Gupta. “The 10% mortality rate for stem cell transplantation must be balanced against the risk of death if nothing is done,” he said.
“Work like this is important for the development of treatment strategies that could be more widely applicable,” commented Dr Andrew Freedman of Cardiff University, who was not involved in the study.
The patient still under surveillance
Other scientists, on the other hand, are more cautious. “Is the London patient really cured?” asked Sharon Lewin of the University of Melbourne. “The data (…) are of course exciting and encouraging, but in the end, only time will tell,” she noted, estimating that it would take “more than a handful of patients cured of HIV” to assess the “probability of a late and unexpected replication of the virus.” The “London patient” will continue to be tested regularly to monitor a possible re-emergence of the virus.
Nearly 38 million people worldwide are living with HIV, but only 62% receive ART. Nearly 800,000 people died in 2018 from HIV-related diseases. The emergence of drug-resistant forms of HIV is also a growing concern.