A London man is only the second to be cured of HIV

Ravindra Gupta first presenting the case at CROI 2019 in Seattle

For the second time in history, a patient suffering from HIV, the AIDS-causing virus, has been cured of the infection, doctors said Tuesday.

Now, writing in the journal Lancet HIV, researchers say that 30 months after stopping antiretroviral drugs - medications that suppress HIV - and 46 months since the transplant, Castillejo remains in remission.

The "London patient," 40-year-old Adam Castillejo, had a bone marrow transplant created to beat an otherwise untreatable blood cancer called Hodgkin's lymphoma, just as his "Berlin patient" predecessor Timothy Ray Brown did to cure his leukemia. "Our results show that the success of stem cell transplantation as a cure for HIV, which was first reported in the Berlin patient nine years ago, can be repeated".

In 2016, he received a transplant of haematopoietic stem cells from a donor carrying a genetic mutation in the HIV receptor CCR5, which hinders the HIV virus from entering human cells.

Lead researcher of the Lancet study, Prof Ravindra Kumar Gupta of the University of Cambridge, said to BBC: "This represents HIV cure with nearly certainty". The 40-year-old patient, Adam Castillejo, who is originally from Venezuela has now come out from the shadows following news of his triumph.

Mr Castillejo, who was diagnosed aged 23, is the second person to be cured of HIV.

Researchers have cautioned that the stemcell transplant cannot be considered as a generalised cure for HIV since Castillejo's treatment was a "last resort" because his blood cancer would likely have killed him.

Said Castillejo: "I don't want people to think, 'Oh, you've been chosen.' No, it just happened". "Everyone believed after the Berlin patient that he nearly needs to die basically to cure HIV, but now maybe not", Gupta told the Times. Bone-marrow donors in both cases did not carry the rare CCR5 gene, which is the gene that serves as a protection against HIV. The goal of stem cell transplantation, in this case, is to make the virus unable to replicate in the patient's body by replacing their immune cells with those of the donor, as body irradiation and chemotherapy targets any residual HIV virus. In 2012, doctors diagnosed him with acute myelogenous leukemia (AML), and he underwent a stem cell transplant. Today, the only approved treatment for HIV are pills to reduce their levels of the virus, to prevent transmission, and improve their quality of life. Wensing is also co-leader of IciStem, a group of scientists studying stem cell transplants to treat HIV.

Researchers are now weighing up whether or not patients suffering from drug-resistant forms of HIV might be eligible for stem cell transplants in future, something Gupta said would require careful ethical consideration.

"This is a unique position to be in, a unique and very humbling position", he told The New York Times.

Most HIV patients can manage the treatment of the virus with drugs available today, and live long and healthy lives.

However, being only the second reported patient to undergo this experimental treatment successfully, the authors note that that the London patient will need continued, but much less frequent, monitoring for re-emergence of the virus. "I do recall when the person told me and the panic set in".

It is fundamentally not possible to cure AIDS to this day.



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