Cure for HIV? Second man cleared of the deadly virus

The world is raising its hopes of finding a cure to the deadly HIV/AIDS virus following reports that a man has been cleared of the virus. The HIV-positive man from Britain is the second person worldwide to be cleared of the AIDS virus after he received a bone marrow transplant from an HIV resistant donor, his doctors said.

Twelve years ago, a patient from America was cleared of the virus after going through the same procedure in Berlin, Germany. Doctors have since tried and failed to duplicate the procedure until now.

Their success has raised possibilities that a cure to the deadly virus is near, even though it might be difficult, expensive and risky.

The second man, who is only being identified as the “London patient” received a transplant of stem cells from a donor who had the rare gene mutation CCR5. The mutation is related to HIV resistance, said Reuters.

The patient stopped taking antiretroviral drugs 19 months ago, and highly
sensitive tests that were taken after showed no trace of the man’s previous HIV infection.

“There is no virus there that we can measure. We can’t detect anything,” said Ravindra Gupta, a professor and HIV biologist who co-led a team of doctors treating the man.

Gupta described his patient as “functionally cured” and “in remission”, but he gave a caution: “It’s too early to say he’s cured.”

The London patient contracted HIV in 2003 and was diagnosed with a type of blood cancer called Hodgkin’s Lymphoma, according to Gupta. In 2016, he became very sick with cancer, hence doctors sought a transplant match for him, in what seemed to be his last chance of survival.

According to Reuters, the donor was unrelated and had a genetic mutation known as ‘CCR5 delta 32’, which confers resistance to HIV.

The transplant went well but there were some side effects; the London patient suffered moments of “graft-versus-host” disease. Gupta described this as a condition in which donor immune cells attack the recipient’s immune cells.

He added that both the Berlin and London patients had this complication, which could have played a role in the loss of HIV-infected cells.

Even though experts have welcomed the results, they have asked people to be cautious due to various factors such as the cost and risk involved, as well as, the difficulties in finding an exact match donor.

“Firstly, the bone marrow transplant in both HIV cure cases were primarily used to treat cancers of the blood and were modified to enable a HIV cure.

“So, the cost-benefit of the prognosis following a bone-marrow transplant versus that on HIV antiretroviral therapy needs serious consideration,” UNSW’s Kirby Institute director Professor Anthony Kelleher said.

“Secondly, naturally resistant and compatible bone marrow donors are rare because of the need for donor-recipient matching. Further, this type of procedure is not widely available in many countries.

“Finally, there is significant morbidity and mortality associated with this type of transplantation, even when conducted in the best centres, and under the best circumstances,” he was quoted by news.com.au.

In spite of the concerns, there is hope for people like Gupta, who told Reuters that his team plans to use these findings to explore potential new HIV treatment strategies.

HIV/AIDS remains a major public health concern and the main cause of death in spite of numerous efforts to control the spread of the disease.

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.

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.

Among this group, 19.6 million are living in East and Southern Africa which saw 800,000 new HIV infections in 2017.

Progress has been made towards UNAIDS’ 90-90-90 targets for prevention and treatment, but this appears to be stalling and at current rates, the targets will not be achieved by the 2020 deadline, statistics show.