Daily Management Review

Second Patient In 12 Years Becomes HIV Free By Bone Marrow Transplantation


03/06/2019




According to reports, a man from London who had been infected with HIV virus has cured and is now free of the virus.
 
Bone marrow from a donor that has a rare genetic mutation was transplanted in the patient, who is now being called the ‘London Patient’. Doctors stopped the regular dosage of antiretroviral drugs to the patient following the transplantation of the bone marrow. This form of treatment went on for 18 months and when the patient now was subjected to highly sensitive tests, it was revealed that the patient contained no traces of the HIV virus within his body.
 
This is the second such reported case of a patient getting free of HIV virus with the use of a similar treatment therapy – the earlier one was 12 years ago. The first such patient was Timothy Brown, also known as the “Berlin Patient”, and she has remained free of the virus after the cure. Doctors have tried the therapy several times since then. The success of the latest attempt has reignited hopes for a cure for HIV infection and many now claim that curing HIV virus is possible even though it is a difficult therapy.
 
A mutation in the gene of CCR5 carried in the bone marrow of donors was transplanted in both the HIV-infected men. The CCR5 is a receptor molecule on the surface of the white blood cells which are involved in the immune system. The CCR5 receptor protein is targeted by the HIV virus when it attacks the human cells. Resistance to HIV is conferred by the mutated CCR5 bone marrow.
 
According to reports, the London Patient became infected with HIV in 2003. A form of blood cancer known as the Hodgkin Lymphoma also developed in him in 2012. Treatment of the patient’s blood cancer was the aim of the transplantation of the mutated bone marrow. The blood cancer led to the deterioration of the condition of the man in 2016 when transplantation as a treatment was decided upon by doctors and was deemed to be the last chance for his survival.
 
Some side effects such as “graft versus host disease” remained in the patient even though the transplantation went smoothly. That side effect results in the recipient’s immune cells being attacked by the donor’s immune cells.
 
While the patient was at the University College of London, UK, the team of doctors treating him was co-led by Virologist Ravindra Gupta, who is now at Cambridge University. While explaining the manner in which the transplantation helped the patient to get rid of the HIV virus, Dr. Gupta also issued a caution against using the word ‘cure’ for the patient but instead be described as ‘functionally cured’ and in ‘long term remission’.
 
Lives of some 35 million people worldwide have been taken by HIV and AIDS since its discovery in the 1980s. Current estimated puts the number of infected at about 37 million.  The development of drug combinations including the antiretroviral drugs which helps to keep away the HIV virus from affecting a patient’s body has been the result of scientific investigation into this complex viral disease. But reduction of the heavy dosage of drugs for patients because of a new treatment strategy could be very helpful for HIV patients. There is certainly some hope of achieving that because of the mutated bone marrow transplantation and the possible cure.
 
(Source:www.newsclick.in)






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