A London man's H.I.V.is in long-term remission following a bone marrow stem cell transplant, making him only the second individual in history to be effectively cured of the virus.
The approach used in both patients entailed the use of stem cell transplants from donors who carried a rare genetic mutation, known as CCR5-delta 32, that made them resistant to HIV.
While a second patient experiencing HIV viral remission with a slightly less toxic cancer treatment is certainly encouraging progress, an 18-month remission does not equal a cure. This gene codes for a receptor which sits on the surface of white blood cells involved in the body's immune response.
Even so, the bone-marrow transplant that appears to have eliminated the virus is too risky, complicated and expensive to serve as a widespread cure.
Prof Gupta's case was in an HIV-positive man with advanced Hodgkin's lymphoma who received a transplant of haematopoietic stem cells from a donor with two copies of the so-called CCR5 gene mutation - the same one allegedly edited by Chinese researcher He Jiankui that led to the birth of the world's first gene-edited babies past year. In addition to chemotherapy, he underwent a haematopoietic stem cell transplant from a donor with two copies of the CCR5 Δ32 allele in 2016. Although it is not a viable large-scale strategy for a cure, it does represent a critical moment in the search for an HIV cure. But with only two cases of people who have been cured of HIV - and the British patient has been "cured" just 18 months - he said it's too soon to tell where this might lead.
The vast majority of people living with HIV are located in low- and middle- income countries, with an estimated 66% living in sub-Saharan Africa.
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"If you transplant those cells into someone who already has HIV, you may protect those new cells from infection", he said. The incoming transplanted donor-immune cells seek out and destroy all the host's immune cells - including those in which HIV can hide out, he said.
Since the beginning of the epidemic, more than 70 million people have been infected with the HIV virus and about 35 million people have died of HIV. His immune cells also remain unable to express the CCR5 receptor. More recently, researchers reported that a bone marrow transplant recipient in Minnesota had viral remission lasting almost 10 months after an analytic treatment interruption, but he too ultimately experienced viral rebound.
The unnamed man who was given the moniker the "London patient" was diagnosed with the virus in 2003. "I never thought that there would be a cure during my lifetime".
This case is the only the second reported case of an adult apparently becoming free of HIV infection. However, this new case adds to the evidence that using gene therapy to delete CCR5 receptors from T cells may be a feasible approach.
"I'm afraid this is perpetuating the myth that the end of AIDS and a cure is imminent", Anderson, 59, said. The "Berlin patient" received treatment for leukaemia (a cancer of the immune system) back in 2007.