Second world remission of an HIV-positive patient

Deuxième cas mondial de rémission d’un patient atteint du VIH

Photo: Jewel Samad Archives Agence France-Presse

For the second time in the world, a patient with the aids virus (HIV) is experiencing durable remission after having interrupted his treatment, a result that opens the perspective to one day cure the disease.

Ten years after the confirmation of the first case of remission in a patient with hiv, who had got rid of this disease, in this second case, known as “the patient” of London, has shown no sign of infringement of the virus for almost 19 months, then he stopped his treatment, reported Tuesday in the journal Nature a team of researchers, who consider it as probably cured.

Both patients underwent bone marrow transplants to treat cancers of the blood, and thus of the stem cell donor carrying a rare genetic mutation that prevents the HIV from getting a foothold.

“It is a result that is date. After 10 years of inability to replicate [the first case], people wondered if it was a stroke of luck, ” says the lead author of the study, Ravindra Gupta, a professor at the University of Cambridge. “It is important to reaffirm that it is real and that it can be done “, he declared to the AFP.

Millions of people infected with HIV throughout the world to control this disease using a treatment by antiretroviral (ARV) drugs, but this therapy does not rid of the virus and should be taken all life.

Bone marrow transplantation — a procedure dangerous and painful — is not a viable option to achieve cure in the majority of patients, take care of stress professor Gupta and his team.

But this second case of forgiveness and healing likely will help scientists reduce the range of treatment strategies.

“It allows our researchers to move forward in our knowledge of what it takes to achieve a cure, thus welcomed Michaela Müller-Trutwin, director of research at the Pasteur Institute, interviewed on RTL.

37 million people are living with HIV in the world, but only 59 % receive a combination therapy. Nearly a million people still die each year from HIV-related conditions. The emergence of forms of HIV that are resistant to drugs is also a growing concern.

“A key moment in the search for a cure to HIV “

The international Society of fight against aids has been hailed ” a key moment in the search for a cure to HIV.” “That gives us a lot of hope that in the future maybe we could end aids through science, by a vaccine or a cure,” commented his part, Michel Sidibé, president of the agency of the United Nations, Unaids.

The “patient” of London and “the patient from Berlin” (nickname of the first case) received injections of stem cells from the donor carrying a genetic mutation that makes inoperative an HIV receptor, CCR5.

This patient uk anonymous had been diagnosed hiv-positive in 2003 and was in antiretroviral therapy since 2012.

Diagnosed also in 2012, an advanced form of Hodgkin’s disease, a cancer of the lymphatic system, it has undergone in 2016, a hematopoietic stem cell transplant from a donor carrying a mutation in the gene for the CCR5, very rare, present in 1 % of Europeans.

Interrupt the HIV life cycle

HIV-1 uses most of the time the CCR5 as a receptor. But this mutation of the gene CCR5 prevents the virus from entering host cells, making the carriers of this mutation are resistant to the aids virus.

“CCR5 is an essential element to ensure that the virus completes its life cycle,” said professor Gupta, according to which this gene “can be eliminated without serious consequence” for the patient.

This is the replacement of immune cells by those who do not have the CCR5 receptor, which seems to be critical to prevent the re-emergence of HIV after the treatment.

After the bone marrow transplant, the “patient” of London has continued antiretroviral treatment for sixteen months, before the interrupt.

Regular tests have confirmed that his viral load was undetectable since.

Timothy Brown, the ” patient Berlin “, had undergone two transplants and irradiation on the whole body.

In contrast, the “patient” of London has not had a single transplant and chemotherapy less aggressive.

Deuxième cas mondial de rémission d’un patient atteint du VIH

Photo: Gerard Julien Archives Agence France-Presse
Timothy Brown, the “patient Berlin”

“I didn’t want to be the only person in the world cured of HIV,” wrote Mr. Brown in a medical journal in 2015, explaining why he had decided to reveal his identity.

The team of researchers presented the findings at the annual Conference on retroviruses and opportunistic infections (CROI) in Seattle, Washington.

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