Having come of age in the time of AIDS, this story is remarkable.
Known as the “London Patient”, a man had HIV and a type of blood cancer called Hodgkin’s lymphoma. He responded successfully to a bone marrow transplant from a donor with rare genetic resistance to HIV infection.
The transplant cleared the man’s cancer and his HIV, but the resistant genes may not be the sole cause of his HIV remission.
Since the pandemic began in the 1980s, more than 70 million people have been infected with HIV and about 35 million have died, most in Africa. Medical advances mean tests can detect HIV early, new drugs can control it, and there are ways to stop it spreading – but 37 million people still live with the virus.
The London Patient’s case gives fresh hope to scientists and pharmaceutical researchers who have spent decades looking for ways to end AIDS. HIV expert Sharon Lewin said two factors were probably at play in his success story: the genetic resistance and a transplant side-effect that attacks immune cells.
Donors carrying the mutation are also rare, so instead specialists want to develop gene therapy to insert the protective variant of the CCR5 gene.
“Continuing our research, we need to understand if we could knock out this receptor in people with HIV, which may be possible with gene therapy,” said the study’s lead author, Professor Ravindra Gupta of University College London and the University of Cambridge.
The breakthrough comes 10 years after the first patient was cured of HIV. Known originally as ‘The Berlin Patient’ and later identified as American Timothy Ray Brown, he also received a transplant of stem cells, yet attempts to replicate his cure have all failed until now.
“At the moment the only way to treat HIV is with medications that suppress the virus, which people need to take for their entire lives,” added Prof Gupta.
“By achieving remission in a second patient we have shown that the Berlin Patient was not an anomaly, and that it really was the treatment approaches that eliminated HIV in these two people.”