May 22, 2019

A cure for HIV? Feasible but not yet realized

10 March 2019, 06:21 | Silvia Roy

A cure for HIV? Feasible but not yet realized

A cure for HIV? Feasible but not yet realized

While bone marrow transplants aren't likely to become standard HIV treatment, Deeks said there's promising research in using gene therapy to alter the CCR5 receptors.

The Dusseldorf patient also received a bone marrow transplant from a donor with the CCR5 mutation.

But just like the protease inhibitors and triple therapy were not a cure in 1996, the eradication of HIV from the bodies of two men across more than a dozen years undergoing stem cell or bone marrow transplants with cells that have the CCR5 genetic mutation is simply not the promise of an impending cure for HIV for at least four important reasons: it is highly unsafe; it is extremely expensive; it is not scalable; and it is not sustainable.

Monthly shots of HIV drugs worked as well as daily pills to control the virus that causes AIDS in two large worldwide tests, researchers reported Thursday.

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This announcement at the Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle comes just two days after the second person in history was announced to be HIV-free on Monday, March 4.

The first such case of an HIV patient being cleared of the virus after a bone marrow transplant happened a decade ago to Timothy Brown, known as the "Berlin patient", who is still free of the virus.

Over 400 representatives from government agencies, global organisations, community-based organisations working with HIV patients, people living with HIV, and media agencies attended the four events. It is typically reserved only for patients who have late-stage cancer and for whom standard cancer treatments have otherwise failed. It is not sustainable, because the CCR5 genetic mutation is also extremely rare, and it is present only in less than 5 percent of individuals born of European dissent.

Earlier this week, researchers announced that they were able to cure the another person's HIV.

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Before Tuesday some researchers had posited a third theory: that it was the intense combination of radiation and chemotherapy ahead of the stem-cell transplant that floored the virus. The Berlin patient had his immune cells replaced with ones from a donor with a genetic mutation that disables a receptor called CCR5.

Walker said another positive sign with this second cure is that in the first case, the transplant nearly killed the patient, but in this case, it did not. It also suggests that this is a promising avenue to pursue in our quest for a long-term HIV cure. Scientists have been monitoring his blood closely, and only one test in that time showed any traces of the virus; they suggest that result could be due to contamination of the test. Maybe the treatment worked exactly as doctors had hoped and allowed his body to build a new immune system that was both cancer-free and protective against HIV.

There are now around 37 million people living with HIV worldwide, and the virus claims around 1 million lives annually. Cells without a working CCR5 receptor are essentially locked up to the virus. For starters, there are two main variants of HIV, one of which is much rarer than the other - and all three patients had the rare variant. Instead of having to keep in mind to take pills, patients instead could get injections from a doctor or nurse each month.

While it proved to be successful for the Berlin, London, and Düsseldorf patients, the strategy used for these cases are not the way to eradicate HIV on a large scale.

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