The existence of a second patient who has been spontaneously cured of HIV infection is confirmed, according to an article published in The Lancet HIV. The first patient cured was Timothy Brown, the “Berlin patient” and the new case of cure is known as the “London patient”. In addition, a third could be added to them, the “Dusseldorf patient”, who has been virus-free for 14 months without antiretroviral treatment.

HIV-positive cured

The article in The Lancet HIV comments that the two cured patients were part of the IciStem program, a collaborative European project that includes a cohort of patients with hematological malignancies who have received an allogeneic stem cell transplant. IciStem has identified 22,000 potential donors who are homozygous for CCR5 Δ32. In addition, 39 patients registered in the program have received transplants, of which only the London and Düsseldorf patients have been cured of HIV.

The authors state that the few cases of purported cures for HIV demonstrate that stem cell transplantation, a treatment that carries its own substantial risks and high mortality, can exceptionally lead to long-term remission of HIV. And that such intervention can only be attempted in people with HIV and haematological malignancies as a last resort and rarely leads to long-term remission of HIV.

But there is still much to learn from the similarities between the cases and stem cell transplant research in people living with HIV. We need to understand the aspects of patients, conditioning regimens and transplants that are needed to be able to eradicate the virus, and in which cases and from what reservoir the virus returns if long-term remission is not achieved. This could help the search for healing strategies.
The authors conclude by saying that the message is clear: HIV is not a curable disease, except for a very small number of people in exceptional circumstances and that the search for a cure continues, which must be well funded, so investment in proven prevention and treatment measures still are important.

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