Today, according to reports in the Wall Street Journal, the New York Times, the Guardian and Science, a London man may have been cured of AIDS after receiving stem cell transplants. That is to say, after Berlin patients, the second successful cure of AIDS patients may have appeared.
Ravindra Gupta, a virologist at University College London who led the study, will present patients in London at the Retroviral and Opportunistic Infections Conference (CROI) in Seattle, Washington, from March 4 to 7, and on Natures website. The paper will be published online in Nature on Tuesday, local time.
At present, the team says it is not possible to conclude that the patient is cured and prefers to use the term long term remission, but the team is closely watching his recovery. Perhaps after about two years of observation, it is more appropriate to talk about the patient has been cured.
Tumen Ravindra Gupta (source: ucl)
About 40 years after the discovery of HIV, there were only 2 rare miracles.
Foreign media reports have shown that the HIV-positive man received a stem cell transplant from a donor with genetic resistance to HIV (CCR5 mutation) three years ago, after which a large number of tests showed that he had no HIV and had stopped using antiretroviral drugs for 20 consecutive months.
Ravindra Gupta says the patient is doing well. The team did not reveal the name of the man, who would be the second person in the history of the human immunodeficiency virus to be cured if he remained uninfected with HIV.
As we all know, the first successful cure for AIDS was the famous Berlin Patient, Timothy Brown, about ten years ago.
Brown was born in 1966 and went to Berlin to study and live in Berlin. During this period, he had several boyfriends. Until 1995, he was shocked (although it seems no surprise to us now) that he was infected with AIDS by his boyfriend.
According to the normal treatment, Brown, who insists on taking medicine, can maintain immunity similar to that of normal people, and can live for decades without any problem. But in 2006, he was diagnosed with acute leukemia.
Browns condition was briefly controlled after receiving chemotherapy, but in 2007 his leukemia relapsed and he decided to have a bone marrow transplant. In particular, the hematologist who treated him made a bold attempt to find a person with AIDS resistance to carry out bone marrow transplantation for him.
The chances of successful matching for bone marrow transplantation are very low, not to mention finding an AIDS-resistant donor. Fortunately, Brown met a suitable donor and had two bone marrow transplants (one relapse).
After the second bone marrow transplantation, Brown almost went through a dangerous doorway, but eventually not only cured leukemia, but also the immune system rebuilt after bone marrow transplantation almost wiped out the HIV virus in his body. Brown had never taken any drugs to treat AIDS after bone marrow transplantation, nor had HIV been detected in his body.
The researchers also compared the similarities and differences between the second London patient and the first Berlin patient. Dr. Gupta said the London patient was diagnosed with AIDS in 2003, Hodgkins lymphoma in 2012 and a stem cell transplant in May 2016.
Both cured patients suffered from diseases other than AIDS and needed stem cell transplantation. Brown had leukemia and needed a transplant, while the London patient had Hodgkins lymphoma. The two had undergone transplantation, but the main purpose of the transplantation was to treat the patients two diseases, not HIV.
But London patients are more effective than Brown because he does not need a second transplant or radiotherapy. The patient took antiretroviral drugs in September 2017 and has been withdrawn since then. This suggests that, compared with Brown, he can discontinue the drug without comprehensive intensive treatment.
In the years following Browns successful transplantation, researchers tried to cure several other patients, but failed. But Gupta said that the new case showed that the cure of the Berlin patient was not an anomaly, and that the two cases also provided new impetus for the development of transplantation therapy based on the two patients.
Sharon Lewin, director of the Peter Doherty Institute of Infection and Immunology at the University of Melbourne, said: When there is only one medical case reported, people always suspect that this may be just an unusual situation. Now the second case is really exciting. It does prove that AIDS can be cured.
Can the medical miracle born by coincidence be duplicated?
Human Immunodeficiency Virus (HIV) is a retrovirus that can infect human immune system cells. Once the HIV virus invades the body cells, it will be integrated with the cells for a lifetime. After several years or longer incubation period, the HIV infected people will develop into AIDS (Acquired Immune Deficiency Syndrome, AIDS) patients. AIDS patients will suffer from severe infections due to the extreme decline of body resistance. Later, they often cause malignant tumors, and eventually die of systemic failure.
(Source: MIT Science and Technology Review)
The terrible thing about HIV is that people can almost achieve complete prevention as long as they adhere to the principle of clean body and self-love; but the terrible thing about HIV is that although many medical researchers around the world have made tremendous efforts, they have not yet developed a specific drug to cure AIDS, and the choice they can make is through some antiretroviral drugs. Drug combination control can prevent most HIV carriers from getting sick for life, but the disadvantage is that they need continuous medication for life.
For tens of millions of people living with HIV, the reality of lifelong medication and incurability is desperate. Does the miracle of Timothy Ray Brown, the worlds second-largest Berlin patient, and the London patient mean that it can be extended to all patients?
Sharon Lewin and other AIDS experts stressed that this approach should not be applied to millions of AIDS patients, with considerable risks and costs.
Researchers involved in the treatment of patients in London also acknowledge that bone marrow transplantation is unlikely to be a realistic treatment option for a long time to come. At present, powerful drugs can be used to control HIV infection, while transplantation is risky and has serious side effects that can last for many years.
As Anthony Fauci, director of the National Institute of Infectious Diseases, said, For patients who do not need stem cell transplantation, this is not a viable solution.
The London man and Brown both received stem cell transplants from donors who had a key mutation in the CCR5 gene. The vast majority of HIV viruses use this normal gene to enter the patients immune system cells.
Studies have shown that mutations in CR5 carried by some people inactivate the gene, thus preventing HIV from penetrating cells. People who inherit CCR5 mutations from both parents will not be infected with HIV even after severe exposure to HIV. According to statistics, only less than 1% of people of European descent have this mutation at the same time.
Experts say it is not clear whether CCR5 resistance is the only key or whether transplantation is equally important for treating host diseases. As mentioned above, both Berlin and London patients have cancer, which may play a role in HIV-infected cells.
Next, Guptas team plans to use these findings to explore potential new strategies for AIDS treatment. We need to find out if we can get rid of this receptor (CCR5) in people living with HIV, and this is possible through gene therapy, he said.
Figure WHO data show that by the end of 2017, 36.9 million people worldwide were infected with HIV. It is estimated that 0.8% of adults aged 15-49 in the world are living with HIV, and the HIV situation is still very different between countries and regions. The African region remains the most severely affected region, with nearly one in 25 adults (4.1%) living with HIV, accounting for nearly two thirds of the worlds HIV-infected population (source: who)
Faced with such a grim reality, although we have not really found a cure for HIV, but with the first batch of healers and the precious healing information among them, we can always clear away some of the fog ahead.
After the publication of this research paper, we will also bring a deep understanding of this paper for the first time.