Thursday, 21 March, 2019

Advances in stem cell treatment give hope to millions with 'incurable' diseases

US Timothy Ray Brown, also known as “The Berlin Patient” considered the first person to be cured of HIV.									GERARD JULIEN  AFP  GettyImages US Timothy Ray Brown, also known as “The Berlin Patient” considered the first person to be cured of HIV. GERARD JULIEN AFP GettyImages
Celia Hoffman | 06 March, 2019, 06:11

According to the New York Times, scientists are now monitoring 38 HIV positive patients, 32 of whom have been given bone-marrow transplants from a donor with the CCR5 gene mutation. To do this in others, exact match donors would have to be found in the tiny proportion of people - majority of northern European descent - who have the CCR5 mutation that makes them resistant to the virus.

Nearly 1 million people die each year from HIV-related causes and the only current treatment available is for the affected to take antiretroviral drugs for their entire lives. The London patient has been in remission for 18 months since he stopped taking antiretroviral drugs.

They say this procedure could be useful now for those rare people with HIV who have also been diagnosed with cancer and in need of a stem-cell transplant to reconstitute their immune systems.

A London man has been in remission from HIV for a year and a half, without drugs, after receiving a stem cell transplant of virus-resistant cells - raising the prospect that he has become the second person to ever be cured of the disease.

During the treatment the patient underwent "graft-versus-host" disease, where the donor's immune cells attack the recipient's immune cells.

"HIV Is Cured In 2nd Patient, Doctors Report". Unlike for Brown, radiotherapy wasn't required and the London patient experienced far less severe consequences than Brown, but Gupta believes the chemotherapy used against the lymphoma was an essential part of its success, temporarily destroying fast-dividing cells so replacement could occur.

There has been only one documented case of HIV, which causes acquired immune deficiency syndrome (AIDS), being cured.

"I think this does change the game a little bit", Gupta opined to NYT of the new patient, who had less invasive treatment than Brown.

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The "London patient" case, cautiously reported in the journal Nature as still too "premature" to be declared a cure, comes a decade after Timothy Brown, known in medical circles as the "Berlin patient" was cured by a similar stem cell transplant, galvanizing the field of HIV research and sparking the search for a cure.

The man has chosen to remain anonymous, with scientists referring to him as "the London patient".

The unnamed man in London has become the second person worldwide to be cleared of HIV, although it is too early to say he has been "cured". He needed both chemotherapy and the stem cells, the combination of which puts a lot of stress on your body. Four years later, doctors gave him a bone marrow transplant, and luckily for him, his donor for the marrow had natural immunity to HIV.

Brown hopes that the "London patient" will survive as long as he has. His drug regiment was much less harsh than the only other known patient who was cured of HIV.

Still, HIV has proven before to be a wily shapeshifter, and except for Brown, people who previously went in remission for various reasons for a year or so have always seen their virus start to replicate again.

The subject of the new study has been in remission for 18 months after his antiretroviral therapy (ARV) was discontinued.

Although the finding is exciting, it is not offering up a new treatment for the millions of people around the world living with HIV.

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