a second patient declared cured of AIDS

The so-called "London patient" is the second patient to have "recovered" from AIDS, ten years after the first. His case is described in the medical journal The Lancet HIV.

The last analyzes, carried out on the 4th March 2023, show that the material genetic of virus is undetectable in the plasma of the patient (sensitivity threshold: 1 copy per milliliter of plasma) but also of cerebrospinal fluid, as well as in the intestinal tissues and lymphoid, and this for thirty consecutive months!

According to scientists, the remains of the genetic material of the virus embedded in the genome cells will not be able to reform virions viable and can be considered " fossils Of the disease.

A second success for hematopoietic stem cell transplantation

The "London patient" underwent graft allogenic from stem cells hematopoietic not expressing the protein CCR5 (CCR5Δ32 / Δ32). This protein present on the surface of leukocytes allows the virus to enter the cell. Some people naturally have this mutation and are therefore protected from infection of the HIV.

This patient was part of the volunteer group of the Icistem project who is studying stem cell transplantation as a treatment against AIDS. The first patient declared cured of AIDS in 2011, the "Berlin patient", had received the same treatment.

HIV: a second patient in lasting remission

Article published on March 9, 2024 by Marie-Céline Ray

This Briton would be the second case in the world of healing of HIV, ten years after "Berlin patient" Timothy Brown. In Great Britain, the "London patient", who remains anonymous, has stopped his treatment and has not shown any signs of virus for 18 months.

In 2017, more than 36 million people worldwide were living with HIV and 940,000 died from a cause related to this virus, according to figures given by theWHO. HIV is a retrovirus that infects cells in the immune system, white blood cells, which helps to weaken the body's defenses. At an advanced stage, the patient is more likely to develop infections and cancers.

The treatment uses a triple therapy with three antiretrovirals but this medication, which must be taken for life, does not cure the infection. In 2017, 21 million people worldwide were taking antiretroviral treatment to control their infection. But today scientists announce that for the second time in history a patient seems to be healed!

Timothy Brown, the "Berlin patient", was the first to be considered cured of HIV; he has had no sign of the virus since 2007. According to a AFP dispatch, the British patient, who remained anonymous, was diagnosed HIV positive for HIV in 2003 and he had been on antiretroviral therapy since 2012. That same year, doctors diagnosed him with Hodgkin cancer.

In 2016, the London patient received a hematopoietic stem cell transplant from a donor who had a mutation in the uncomfortable CCR5, called CCR5 delta 32. Hematopoietic stem cells are capable of regenerating blood cells, and in particular white blood cells. CCR5 is an HIV receptor; when this protein is mutated, it prevents the virus from entering the cell.

Patients who have had stem cell transplants

After the transplant, the patient continued on antiretroviral therapy for 16 months and then stopped it. Medical examinations have shown that his viral load had become undetectable.

However, the treatment received by the "London patient" seems difficult to generalize to all patients, because it is very heavy. But this major advance brings interesting information to scientists to cope with the disease and imagine treatment strategies, for example with gene therapies.

Timothy Brown had also received stem cells from a donor with the CCR5 delta 32 mutation. He also suffered from blood cancer, a leukemia. He had two transplants and had one irradiation, while the London patient had only one transplant and one chemotherapy. Ravindra Gupta, a professor at the University of Cambridge, said: "By arriving at a remission on a second patient while using a similar approach we showed that the Berlin patient was not a anomaly. "

These results to appear in the review Nature must be officially announced during a conference this Tuesday, March 5, 2024 during a congress in Seattle.

HIV: a British patient cured of AIDS? (Update)

Article published on October 4, 2016

The British press reports on an encouraging first result obtained in a clinical Review where a man had no detectable HIV virus in his blood. Other treatments being tested have suggested that it is possible to get rid of HIV permanently.

The british press announces the first results of a clinical trial involving 50 people, after which a man no longer had any HIV virus in his blood. But beware, these results are still early; prudence remains in order pending the full results and an official publication.

The treatment tested comprises several stages and is original in that it attacks the cells in which the virus remains sleeping. First, anti-retrovirals stop HIV; then a drug (Vorinostat) activates lymphocytes T dormant to force them to express HIV proteins. These cells will be suppressed by the immune system, which has learned to recognize HIV through a vaccine.

In 2007, an American, Timothy Brown, nicknamed the "Berlin patient", was cured of HIV through a transplant from bone marrow to treat his leukemia. He is officially the only patient cured of HIV. It will therefore be necessary to wait to see how the condition of this Briton will evolve over time to confirm a cure.

———-

Initial article by Janlou Chaput, published on 07/27/2012

The AIDS conference could keep its promises of hope. Two American patients are said to have recovered from AIDS and twelve French people have survived with HIV without any treatment for 6 years without the disease progressing. The solution is getting closer …

All hopes are allowed. After the unique case of the "Berlin patient", aka Timothy Brown, the only person officially cured of AIDS, the list could expand with two new names. Indeed, during the XIX^th annual International AIDS Conference, which was held from July 22 to 27 in Washington, two speakers from Brigham and Women’s Hospital from Boston have announced that they are following two patients in whom there is no longer any trace of HIV. Scientists remain very cautious and do not yet speak of a cure, further analyzes being necessary. But the current data has reason to be optimistic.

The story has many similarities to that of Timothy Brown, but also some differences. The man, in addition to an HIV infection, suffered from leukemia. To treat his cancer, he had received bone marrow transplant a donor with a genetic mutation that prevented the virus from entering cells. He has since been released from AIDS.

Two special cases that cure AIDS

The two Americans HIV positive were affected by lymphoma, a cancer that also attacks cells of the immune system. Their triple therapy had to be stopped before starting treatment for their tumor, giving the virus the opportunity to come out of its latent state and start its infectious process again. Against their Cancer, the patients also benefited from grafts bone marrow, but this time the donors were not protected against AIDS.

Just before the transplant, and just after, the HIV genome was detectable in their cells. But 8 months later transplantation, the virus no longer left any trace either in blood plasma or in cultured cells, despite the use of the most sensitive detection tests. Today, respectively 2 and 3 and a half years after the operation, the viremia remains undetectable.

The two men stay under antiretroviral as long as the remission is not confirmed, and this can only be confirmed later, after further analyzes. This therapy, if it ultimately proves effective, cannot however constitute a global solution for all HIV-positive patients, for several reasons.

Indeed, the two men are not like the majority of patients: they naturally benefit from a mutation which makes them more resistant to HIV infection. This may play a role in the effectiveness of therapy, as suggested by failures in patients without genetic modification. In addition, the bone marrow transplant is perilous and the risks of death following the operation are higher than those of dying from AIDS. It is therefore banned for HIV positive people without blood cancer.

Living normally with HIV without triple therapy

Another study was much talked about during this same conference. It is French and announced by the National Agency for Research on AIDS and hepatitis ((ANRS). This time, there is no question of remission but simply stopping treatment without progress of the disease. Twelve of the fifteen subjects no longer take any drug for 6 years and are not doing any worse.

The subtlety is that all these patients started treatment antiretroviral in the first 10 weeks after HIV infection, which represents early management, the time before finding the contamination often being longer.

After 3 years of triple therapy, theOrleans hospital asked them to stop their medication and follows each of these patients very precisely. For the vast majority of them, viremia remains undetectable, just as if they were still on treatment. However, it has been 6 years since they swallowed a pill.

This is great news because people HIV positive are condemned to take their medication for life, which does not eliminate HIV but keeps it at very low rates. This shows that it is sometimes possible to live a completely normal life, even if you are infected with the AIDS virus. In addition, this discovery could open new avenues for understanding the mechanism and trying to generalize it to all patients.

The fight against AIDS proves that it is still active and that complete remission is not utopian. Unfortunately, the world without HIV is not yet tomorrow, and the virus will still cause many death across the planet …