London patient ‘free’ of HIV after stem cell transplant
Man treated in UK is only the second person ever to go into remission from the virus
A man treated in the UK has become only the second person ever to go into remission from HIV, raising hopes of progress in finding a cure for a condition that affects 37m people worldwide.
As in the first case — in Berlin 10 years ago — the man, known only as “the London patient”, received a bone marrow stem cell transplant from a donor who was HIV resistant, researchers say.
The report on the case, authored by researchers at UCL and Imperial College London and published in Nature on Tuesday, said the patient had been in remission for the 18 months since he stopped taking antiretroviral therapy and seemed to be free of the virus, which can lead to Aids.
Prof Eduardo Olavarria from Imperial College London, one of the authors of the report, stressed it was too early to say with certainty that the patient was “cured” of HIV. But, he said, “the apparent success of hematopoietic stem cell transplantation offers hope in the search for a long-awaited cure”.
Prof Ravindra Gupta of UCL, the study’s lead author, said: “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, posing a particular challenge in developing countries. Finding a way to eliminate the virus entirely is an urgent global priority, but is particularly difficult because the virus integrates into the white blood cells of its host.”
Other researchers sounded a note of caution. “The report of a second case of HIV remission is of great interest but does not move the scientific field forward very significantly over the Berlin patient,” Prof Sarah Fidler of Imperial College London said.
“Rather, it reinforces the science that this is rare but feasible. The treatment this patient received is not safe and not scalable. It is certainly not an option to be recommended for people living with HIV who are doing well on antiretroviral therapy.”
Stem cell transplants are risky and only done when there is a clinical reason. Both the London and Berlin patients received one as part of treatment for cancer. In addition, HIV-resistant donors are rare.
Nevertheless, the case “represents a world-class UK contribution to cutting edge clinical science,” she added.
Anton Pozniak, president of the International Aids Society, said that although the approach was not a viable large-scale strategy for a cure, it represented a critical moment.
“These new findings reaffirm our belief that there exists a proof of concept that HIV is curable. The hope is that this will eventually lead to a safe, cost-effective and easy strategy to achieve these results using gene technology or antibody techniques,” he said.
Almost 37m people worldwide are living with HIV and about 1m people a year die from HIV-related causes. About 59 per cent of those with the condition are receiving antiretroviral therapy.
Despite fears of new drug-resistant strains of HIV, UNAids, the body co-ordinating the global response to the disease, says new infections have fallen by 47 per cent since the peak in 1996 and Aids-related deaths have fallen by more than half since they peaked in 2004. The UN’s stated goal is to end Aids as a public health threat by 2030.