The London Patient and an HIV ‘Cure’: What You Need to Know

(Like the London patient, the Düsseldorf patient's identity has been concealed for privacy.) Post-bone marrow transplant, the Düsseldorf patient's gut and lymph node biopsies revealed no infectious HIV after three months off of an antiviral drug regimen.

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. It is noted that about "düsseldorf patient", the doctors spoke at the Annual conference on retroviruses and opportunistic infections.

The man is being called "the London patient", in part because his case is similar to the first known case of a functional cure of HIV - in an American man, Timothy Brown, who became known as the Berlin patient when he underwent similar treatment in Germany in 2007 which also cleared his HIV. "Meanwhile focus needs to be on diagnosing HIV patients promptly and starting them on the lifelong cART treatment to help prevent further spread of the virus and provide the opportunity for those infected to live near normal life expectancy".

Condoms remain the most widely available and low-cost form of HIV prevention.

Top panel illustrates the treatment course for the London patient. What saved them both were stem cell transplants from bone marrow donors - last-ditch attempts to save them from the cancers.

The donor - who was unrelated - had a genetic mutation known as "CCR5 delta 32", which confers resistance to HIV. In 1997, David Ho of the Aaron Diamond Institute announced that the new crop of anti-retroviral drugs would probably be able to knock out the virus in patients after they continued the regimen for a number of years.

The transplant involves killing nearly all the immune cells and replacing them with donor cells, and is so risky it can only be carried out on people with cancer.

It has been 12 years since the first HIV-cured patient was reported. Scientists are describing the condition as a long-term remission, but the news has given hope for a cure. A small amount of people who are resistant to HIV have two mutated copies of this receptor; meaning the virus can't penetrate the cells it would normally infect.

Also, while the London patient's cancer treatment was less intense, with just chemotherapy and the stem cell transplant, it was still toxic and is not a course of treatment that otherwise healthy people living with HIV infection should embark upon. He has now been HIV-free without medication for 18 months.

The vast majority of HIV virus strains use the CCR5 molecule, or receptor, as the port of entry into human cells.

According to the United Nations, there are an estimated 37 million people worldwide living with HIV.

Most importantly, the HIV community learned that Brown's case was not unique.

HIV is the virus that causes AIDS.

Similarly, access to two prevention interventions called PEP, or post-exposure prophylaxis, where patients take a one month course of the HIV cocktail after possible exposure to HIV, and PrEP, or pre-exposure prophylaxis, where patients at risk of contracting HIV take one daily pill of the HIV-treatment drug Truvada, are extremely effective at preventing new infections among those most at risk.

Vanessa Coleman

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