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Study supports claim HIV cure

Study supports claim of HIV cure in a second patient. No rebound of HIV in the London Patient who has stopped antiretroviral therapy after a successful stem cell transplantation to treat his hematological disease.

The so-called London Patient (IciStem patient #36) underwent a stem cell transplantation as part of his cancer treatment. The transplanted donor cells had a gene defect (CCR5delta32mutant), which renders these donor cells resistant against most HIV variants. Now, our study shows that 30 months after stopping antiretroviral therapy, no viral rebound has been observed in the London Patient.

This is the longest HIV remission after stem cell transplantation since the Berlin patient, who was the first person cured of HIV. Although traces of HIV were found in the Berlin Patient, HIV never rebounded and he is now celebrating his 13th  anniversary of being cured. The transplanted cells from a CCR5delta32 donor most likely protected his immune system. He also received aggressive chemotherapy, total body irradiation and two stem cell transplants. For over a decade, the HIV field has been puzzled regarding which of these factors were essential for his cure.

Professor Ravi Gupta of the University College London and the University of Cambridge, published a late-breaker abstract at CROI and an article on the London Patient in The Lancet HIV. In absence of a viral rebound 30 months after treatment interruption, several blood, semen, cerebrospinal fluid and tissue samples, including gut, lymph node and rectal tissue, were assessed. Using an arsenal of ultrasensitive techniques low levels of HIV DNA could be detected in lymph node tissue and blood cells, whereas HIV was undetectable in all other samples. Importantly, we demonstrated that the low levels of DNA that could be detected did not represent intact replication competent virus. The HIV DNA traces were also found in the first patient to be cured, the Berlin Patient. Scientists suggest that these remains can be considered as “fossils”, since they are incapable of reproducing the virus.

Dr. Björn Jensen of the Heinrich Heine University in Dusseldorf presented another HIV-infected patient (IciStem patient #19) who received a stem cell transplantation with these special donor cells (CCR5delta32mutant). The Dusseldorf patient interrupted his antiretroviral therapy 14 months ago and no viral rebound has been detected ever since. At CROI, it was demonstrated that no HIV DNA could be detected in blood T-cell subsets and gut biopsies (duodenum, ileum and rectum). In lymph node and gastrointestinal tract tissues traces of HIV DNA were shown using DNA scope. Since all functional assays were negative, it is likely that these traces do not represent replication competent virus. These results are compatible with sustained remission of HIV.

The IciStem project is supported by AmfAR Research Consortium on HIV eradication (ARCHE) Research Grant # 109858-64-RSRL and the Aidsfonds

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