Another patient who received a bone marrow transplant from a donor with natural immunity to the HIV virus in Berlin 10 years ago also ended up in remission from HIV. Brown has previously spoken of how he counts the date of the first stem cell treatment-February 6, 2007-as a new birthdate of sorts, because it was on this day that, unbeknownst to his doctors at the time, he would apparently be cured of HIV.
Another patient is hailed as HIV-free after a bone marrow transplant from a donor with a rare genetic mutation. (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.
When an HIV positive patient achieves viral suppression and has an undetectable viral load, not only do they have a significantly increased likelihood of improved health outcomes, but it also eliminates their likelihood of transmitting HIV. This CCR5 receptor mutation - present in about one percent of people of European descent - prevents HIV viruses from entering immune cells. As part of his treatment for leukemia, which is a cancer of the immune system, his immune cells were destroyed and replaced with donor cells with the mutation.
"This will inspire people that cure is not a dream", Wensing said.
Gaining better understandings of how the body can naturally resist infection offers hope of a cure, even if it still remains just out of grasp; this success of stem cell transplantation provides renewed hoped that strategies may be developed to tackle the virus as expanding remission to those affected disproportionately is important.
Top panel illustrates the treatment course for the London patient.
Given recent disappointments after hematopoietic stem cell transplantations in people living with HIV, the team reporting on remission of the London patient does not describe their patient as cured. "At the moment HIV isn't cured". The patient must then be monitored to insure that his or her HIV does not come roaring back. When HIV-infected individuals are compliant with the prescribed use of the AIDS cocktail, their viral load is undetectable and they become untransmittable, meaning they can not sexually transmit the HIV virus to others. HIV uses the protein to enter the cell, but it can not attach to the mutated version.
The patient received the bone-marrow transplant in May 2016.
While a second patient experiencing HIV viral remission with a slightly less toxic cancer treatment is certainly encouraging progress, an 18-month remission does not equal a cure.