08 Mar 2019
Second man experiencing HIV remission
Ten years after Timothy Ray Brown, also known as the Berlin Patient, became the first person to be functionally cured of HIV, another man being hailed the London Patient, is now also experiencing HIV remission.
Research published this week in Nature describes the case in which the London Patient was diagnosed with advanced Hodgkin’s lymphoma, requiring a stem cell transplant from a donor with two copies of the mutation of CCR5.
CCR5 is a protein on the surface of white blood cells, and a co-receptor for most strains of HIV infection. About 1% of Caucasians carry a mutation in CCR5 and are therefore resistant to HIV.
The research team, led my Professor Ravindra Gupta from the University of Cambridge, described a similar but less aggressive approach for the London Patient than what was used for the Berlin Patient a decade ago.
The London Patient also received a stem cell transplant from a CCR5 negative donorand 16 months after the transplant, stopped antiretroviral therapy (ART). Usually virus rapidly rebounds within 2-3 weeks after stopping ART, but the virus in this man has not returned. He has now been off ART for 19 months.
Doherty Institute Director, Professor Sharon Lewin who has dedicated her clinical and research career to finding a cure for HIV said this was a big deal.
“The 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. This is a long time to be in remission off ART, so this is exciting,” Professor Lewin said.
“Coming 10 years after the successful report of the Berlin Patient, this new case confirms that stem cell transplantation from a CCR5-negative donor can eliminate residual virus and stop any traces of virus from rebounding.
“Two factors are likely at play – the new bone marrow is resistant to HIV and also the new bone marrow is actively eliminating any HIV-infected cells through something called graft versus host disease. There are similarities with the Berlin Patient case, but there are also differences.”