Second-Ever Patient Cured of HIV
Following a stem-cell transplant, a man in the United Kingdom has become the second patient to be declared cured of HIV infection, according to a new piece published in Lancet HIV.
“The London patient (participant 36 in the IciStem cohort) underwent allogeneic stem-cell transplantation with cells that did not express CCR5 (CCR5Δ32/Δ32),” the authors wrote. Remission was observed at 18 months after analytical treatment interruption (ATI), with the newly published work providing data at 30 months following ATI.1
A similar treatment was responsible for the first patient reported as being cured of HIV infection in 2011 (“the Berlin patient”). The London patient was first reported as “free” of HIV in March of 2019.
“After extensive tissue sampling completed by 3.5 years after ATI, the Berlin patient was reported as being cured from HIV-1. The London patient has been in HIV remission for 30 months (as of March 4, 2020), with plasma negative for HIV-1 RNA (<1 copy per mL) and semen negative at less than 12 copies per mL at 21 months,” the researchers wrote.1
However, lead author Ravindra Kumar Gupta, MA, BMBCh, MPH, PhD, from the University of Cambridge, cautions against seeing the new development as a potential widespread cure.
"It is important to note that this curative treatment is high-risk and only used as a last resort for patients with HIV who also have life-threatening hematological malignancies. Therefore, this is not a treatment that would be offered widely to patients with HIV who are on successful anti-retroviral treatment," Dr Gupta said in an interview with BBC.2
“Despite showing (in both the London patient and the Berlin patient) that CCR5-directed approaches can lead to long-term remission of HIV-1, several barriers remain to be overcome (eg, gene editing efficiency and robust safety data) before CCR5 gene editing can be used as a scalable cure strategy for HIV-1,” they concluded.1
—Michael Potts
Reference:
Gupta RK, Peppa D, Hill A, et al. Evidence for HIV-1 cure after CCR5Δ32/Δ32 allogeneic haemopoietic stem-cell transplantation 30 months post analytical treatment interruption: a case report [published online March 10, 2020]. Lancet HIV. https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(20)30069-2/fulltext.
This research was also presented at CROI 2020:
Gupta RK, Peppa D, Pace M, et al. Sustained HIV remission in the London patient: the case for HIV cure. Paper presented at: Conference on Retroviruses and Opportunistic Infections 2020; March 8-11, 2020; Boston, MA. http://www.croiconference.org/sessions/sustained-hiv-remission-london-patient-case-hiv-cure.