SHARES
HIV cure is the ultimate goal for HIV research. Currently, there are 37 million people worldwide with HIV infections. The disease has killed nearly 35 million since the virus exploded in the 1980s. Each year, nearly 1 million people die from HIV-related causes. The statistics reveal the significance of the world’s public health challenge, growing at alarming rates in some parts of the world.
Although, about a decade ago the world saw an opportunity at a HIV cure. This was the case of the “The Berlin patient”. About a decade later, we get to hear of a second case in 2019
HIV Cure Remission
Timothy Brown, the “The Berlin patient” was the first person achieving a HIV cure. During the Conference on Retroviruses and Opportunistic Infections, in 2008, his doctors announced Timothy Brown’s case a successful cure.
After that for years, doctors attempted to replicate the treatment with other HIV-positive cancer patients. It was not until 2019, the current patient, who was diagnosed with Hodgkin’s lymphoma in 2012, that doctors achieved the same results. Nearly 18 months after coming off the antiretroviral therapy, a man in London is in remission from HIV. This makes him the second known adult to be in remission.
The patient – “The London patient” — received a bone marrow transplant from a donor carrying a genetic mutation that resists the HIV virus. Both patients received stem cell transplants from donors with the rare genetic mutation known as ‘CCR5 delta 32.’
HIV Cure – how is works
Normally, the HIV-1 virus enters host cells via CCR5 receptors, the most common entry receptor . This specific gene mutation — CCR5 delta 32 — prevents the virus from using CCR5 as a receptor to infiltrate cells. In other words, the HIV-1 virus won’t be able to exist once the CCR5 receptors are blocked. Obviously from the findings, many doctors believe that replacing the host’s immune cells with donor cells that block CCR5 receptors seems to be a way to prevent the HIV from returning after treatment.
The research team published their findings in the medical journal Nature in March 2019. They also presented details of the case at the March 2019 Conference on Retroviruses and Opportunistic Infections in Seattle.
In a March 2020 Lancet HIV Journal update, researchers declared that more than 2 years after the transplant, “The London patient”— is still living, cancer free and HIV free. Lead author Ravindra Kumar Gupta, Ph.D., a professor at the University of Cambridge UK said: “Our findings show that the success of stem-cell transplantation as a cure for HIV, first reported twelve years ago in the Berlin patient, can be replicated,”
Eliminating AIDS is a global priority
Current antiretroviral therapy is safe and effective at suppressing HIV to undetectable levels. It prevents transmission, allows restoration of immune function often to normal levels, and enables people to achieve normal life expectancy.
Those with the virus must take the drugs their entire life as it is a life long treatment. However this is incredibly challenging for some, as the side effects of these drugs can drive them to quit.
Many new treatment options are emerging from the latest gene research. One option may be gene therapy, which could potentially edit the CCR5 receptor in HIV patients. The aim is to produce a mutation which could block CCR5 receptors, preventing the HIV virus from entering human cells. Another option is to pump in neutralizing antibodies derived from genetically engineered immune B cells.
Conclusion
Despite evidence showing CCR5-directed approach can lead to long-term remission of HIV-1, there are still hurdles before CCR5 gene editing can be a cure strategy. We need to understand more about gene editing – the safety and efficiency from more robust clinical trial data.
Looking forward, researchers hope to use these two cases to develop effective new strategies for treating HIV. Here’s hoping the end to HIV is nearing soon.
References
Evidence for HIV-1 cure -https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(20)30069-2/fulltext May 2020, accessed 27 Nov 2020
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by Yashwini Ravindranath
Born & raised in Malaysia, Yashwini earned her M.D. studying in Moscow's Russian National Research Medical University. With an affiliation towards research, all things coffee and the startup ecosystem, she now contributes articles to GetDocSays View all articles by Yashwini Ravindranath.
