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March 14, 2019
Although the AIDS epidemic has ebbed, HIV infection remains prevalent, with about 5,000 new infections per day and nearly 37 million living with the virus. Thus, news this week that a second and third HIV infected patient appear to have recently been “cured” of the infection has kindled hope in the medical and patient communities.
The first new case, described in the journal Nature, is the “London patient,” whose infection was apparently clear 18 months after a stem cell transplant for advanced Hodgkin’s lymphoma. It mirrors the treatment a decade ago of the “Berlin patient,” also a cancer patient who received a stem cell transplant, who remains free of HIV today.
“By achieving remission in a second patient using a similar approach, we have shown that the Berlin Patient was not an anomaly and that it really was the treatment approaches that eliminated HIV in these two people,” Ravindra Gupta, lead author of the study and a professor in University College London’s Division of Infection and Immunity, told CNN.
A third case, presented last week at a Seattle conference but not yet published in a peer-reviewed journal, is the “Dusseldorf patient,” who also underwent a stem cell transplant, in his case to treat blood cancer, and reportedly has shown evidence of being HIV free for three months.
In all three cases, the donor stem cells reportedly had a genetic mutation associated with HIV resistance.
Many obstacles remain
The progress comes with an abundance of caution, however. Many other attempts to replicate the Berlin patient’s success have failed, and the treatment is risky. “There are several dangerous and potential deadly risk factors with a hematopoietic stem cell transplant; including toxicity from preparative chemotherapy, acute and chronic graft-versus-host disease, and infection,” Dr. Joshua Mansour, a board-certified hematologist and oncologist who specializes in stem cell transplantation and cellular immunotherapy, told U.S. News & World Report.
Others have questioned the scalability and economic viability of such a treatment. Researchers hope to develop cures—perhaps based in gene therapy or gene editing—that harness HIV resistance without stem cell transplant.
As Dr. Steve Deeks, an AIDS specialist at the University of California, San Francisco, said, “The whole approach to a cure is shifting more from aspiration to something that people are realizing could be feasible.”
Support for researchers
Any scalable cure would require years of research and trials, and human biospecimens, like those available on the iSpecimen Marketplace, will likely be required for the work. Researchers can search the marketplace for tissues, biofluids and cells by myriad attributes, including diagnosis, patient demographics, medications, and past procedures.
Here’s hoping the second and third HIV cures are followed as soon as possible by the hundredth, thousandth and millionth.
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