London patient might be second to be cured of HIV

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A London man is believed to be the second person ever to be cured of the HIV virus after he received a bone-marrow transplant, his doctors reported Monday.

He later developed cancer and agreed to undergo a bone-marrow transplant for treatment.

According to Reuters, experts say that it may not be possible to widely adopt the procedure given its complexity and the difficulty of finding donor matches who have the HIV-resistant genetic mutation.

But there was something unusual about the person who gave the London patient stem cells. In one example, Pablo Tebas, an infectious disease specialist at the University of Pennsylvania, and his co-workers remove white blood cells from HIV-infected people and then knock out their CCR5 genes with a genome editor called zinc finger nucleases, a precursor to the better known CRISPR. To treat the cancer, the London patient agreed to a treatment called a stem cell transplant. Instead, they say the patient is in remission. He is tested often, and his HIV viral load is undetectable.

The London patient, whose case is set to be presented at a medical conference in Seattle on Tuesday, has asked his medical team not to reveal his name, age, nationality or other details. He was diagnosed with HIV in 2003.

The important point here is that it had been assumed that there might be something special about the Berlin patient, but now "we know it is reproducible", said Hütter, who was not involved in the London patient's treatment. People who have two mutated copies of the CCR5 allele are resistant to the HIV-1 virus strain that uses this receptor, as the virus can not enter host cells.

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"Finding a way to eliminate the virus entirely is an urgent global priority, but is particularly hard because the virus integrates into the white blood cells of its host", said the study's lead author, Professor Ravindra Gupta from the University of Cambridge, who led the study while at UCL. Timothy Henrich, now at the University of California at San Francisco, and colleagues attempted to reproduce Brown's cure in two cancer patients in Boston, but in those cases the donors had normal or "wild-type" stem cells that remained susceptible to HIV, they received less intensive chemotherapy and they stayed on antiretroviral therapy.

The transplant went relatively smoothly, Gupta said, but there were some side effects, including the patient suffering a period of "graft-versus-host" disease - a condition in which donor immune cells attack the recipient's immune cells.

Twelves years ago, to the day, news about the first patient cured of HIV was announced - something researchers had been struggling to do for a very long time.

Ravindra Gupta, a professor and HIV biologist, took charge of the team of doctors treating the man in question.

"We've always wondered whether all that conditioning, a massive amount of destruction to his immune system, explained why Timothy was cured but no one else", AIDS expert Dr. Steven Deeks, who has worked with Brown medically, told NYT. However, this new case adds to the evidence that using gene therapy to delete CCR5 receptors from T cells may be a feasible approach.

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