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Researchers: London man becomes second patient to survive HIV

Timothy Ray Brown, posing for a photo Monday

Timothy Ray Brown, posing for a photo Monday in Seattle, is known as the "Berlin patient," the first person to be cured of HIV infection. Now researchers are reporting a second patient has lived 18 months after stopping HIV treatment without sign of the virus following a stem-cell transplant. Credit: AP/Manuel Valdes

A man known only as the London Patient is the second in the world to be pronounced cured of HIV by way of a bone marrow transplant, but the director of a leading center for the treatment of the infection on Long Island pointed to less-invasive methods  of effectively addressing the virus.

Word of the London Patient came nearly 12 years to the day when doctors in Germany announced the cure of Timothy Brown, known at the time as the Berlin Patient. The new case study was published Monday in the journal Nature and presented Tuesday in Seattle at the Conference on Retroviruses and Opportunistic Infections by the British team involved in the patient’s treatment.

The London Patient has been in remission for 18 months following a bone marrow transplant  that suffused his immune system with healthy stem cells, progenitors of infection-fighting components capable of defeating HIV, the human immunodeficiency virus, doctors said.

Brown, the Berlin Patient, also underwent a bone marrow transplant for treatment of his HIV infection. He told Newsday in a 2015 interview the same transplant also cured him of acute myeloid leukemia. The treatment, he said, gave his immune system a clean slate. His cure was verified by doctors at the National Institutes of Health in Bethesda, Maryland.

“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,” Dr. Ravindra Gupta said in a statement Tuesday. He led a consortium of physicians and scientists from Imperial College London, the University College London, Cambridge University and Oxford University who were involved in the patient’s case.

“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,” Gupta said.

Bone marrow transplants are formidable treatments, Dr. Joseph McGowan, medical director of Northwell Health’s Center for AIDS Research and Training in Manhasset, said in an email Tuesday. McGowan is attending the same Seattle conference as the team that treated the London Patient.

A bone marrow transplant requires the infusion of chemotherapy, sometimes accompanied by radiation, to destroy a patient’s diseased blood-forming tissues in the bone marrow. Healthy marrow from a donor is then infused by IV afterward, priming the body to produce healthy new oxygen-carrying red blood cells and white blood cells that fight infections.

“Both cases of people being effectively cured to date required bone marrow transplants to treat life-threatening conditions,” McGowan said. “Current antiretroviral therapy is safe and effective at suppressing HIV to undetectable levels, preventing HIV transmission, allowing restoration of immune function often to normal levels, and can allow people to achieve normal life expectancy."

McGowan added that treatments for HIV are becoming so simplified that a single pill contains a full treatment regimen.

Last week, doctors at the National Institute of Allergy and Infectious Diseases announced a clinical trial for an experimental HIV treatment involving a once-a-month injection, aimed at suppressing the virus to undetectable levels.

There are serious limitations to bone marrow transplants, which can be risky, McGowan said. Patients are vulnerable to a host of complications, including life-threatening infections. If the patient’s own bone marrow is not completely obliterated, he added, residual cells might harbor the virus. There’s also the need to find a matching donor, which can be difficult, if not impossible. 

“Any potential cure would have to be at least as safe and effective as standard antiretroviral treatments,” McGowan said.

The London Patient was diagnosed with HIV in 2003 but did not start antiretroviral therapy until 2012, according to a news release from Imperial College London. The patient developed non-Hodgkins lymphoma that year.

Both the London and Berlin patients were treated with stem cell transplants from donors carrying a genetic mutation — CCR5 — that blocks HIV.

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