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News that HIV has been wiped from the system of a man for only the second time in history has been welcomed by scientists, but those working in the field are already looking to treatments more suitable for widespread use.

In a paper published in the journal Nature, a team of scientists working at Cambridge University, Imperial College London and University College London offered hope that a future cure for HIV is possible. The scientists transplanted bone marrow into the body of an HIV-positive man known only as the “London patient” after he was diagnosed with Hodgkin’s lymphoma in 2012. He has lived with HIV since 2003.


Doctors have found no trace of the virus in his body for the last 18 months and he has stopped taking antiretroviral drugs, bolstering the case that the original “Berlin patient” cured more than a decade ago was not a fluke.

The breakthrough, led by professor Ravindra Gupta, offers hope for some of the estimated 36.9 million people currently living with HIV/AIDS. Around 35.4 million people have died from AIDS-related illnesses since the start of the epidemic in the 1980s.

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"By achieving remission in a second patient using a similar approach, we have shown that the Berlin patient was not an anomaly, and that it really was the treatment approaches that eliminated HIV in these two people," says Gupta.

Experts applauded the achievement as the proof needed to move forward with research involving stem cells and HIV. “This is an exciting because it's basically repeated the proof of concept,” says professor Sharon Lewin, director of the Peter Doherty Institute for Infection and Immunity at The University of Melbourne, who is also working on research involving cancer treatment and HIV. “That gives us greater confidence that this is a feasible pathway to pursue”.


The unnamed man was given chemotherapy and then transplanted bone marrow from a donor who has a genetic mutation known as CCR5 delta 32, which makes a tiny number of people worldwide resistant to HIV.

“You have to match the donor and the recipient by their immunological footprints, and you need a pretty good match to make sure the bone marrow doesn't react against the recipient,” says Lewin. “They also looked to see if they could find a donor who was also CCR5 negative and those donors are quite hard to find because only about one per cent of Caucasians are CCR5 negative.”

After receiving the stem cell transplant, the London patient had “only a mild reaction”, the paper’s authors found, providing further support for the development of approaches using gene therapy as a strategy for tackling HIV.

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His treatment was described as less aggressive than that received by Timothy Brown, the American who is often described as the first person “cured” of HIV/Aids after undergoing radiotherapy for leukaemia and two stem cell transplants in 2007. Brown’s HIV remains in remission to this day.


Professor Gupta, the report’s lead author, has described the transplant as his patient’s “last chance of survival”, and others noted it would not be suitable for widespread use.

“This is pretty radical treatment so generally not advised except in the setting of a blood cancer like lymphoma. However, it shows concept and if the ‘cure’ persists it will then support cure in the Berlin patient as a concept,” says Professor Linda-Gail Bekker, deputy director of the Desmond Tutu HIV Centre at University of Cape Town.

While doctors and scientists broadly praised the breakthrough, most are already looking ahead to less cumbersome treatments involving genetic modification of cells rather than the onerous search for a compatible donor with the incredibly rare genetic gift of HIV resistance. “I think increasingly it is becoming clear that gene manipulation can be a tool for managing a number of complex disease entities including in the cancer field,” Bekker says.

Timothy Henrich, an associate professor of Medicine at the University of California San Francisco (UCSF), says that the extreme stress of combining chemo- or radiotherapy with bone marrow transplants made genetic modification a more palatable choice for tackling HIV. “Trying to modify cells to be resistant to various strains of HIV, but without the morbidity or mortality of a full stem cell transplantation, is an appealing and logical next step,” he says.

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Using CRISPR gene editing technology, scientists are currently exploring how to “knock out” the CCR5 gene that allows the HIV virus to penetrate cells, though the recent controversy of the Chinese scientist who claimed to have done this in two human embryos looms large.

Lewin also emphasised the potential of single cell RNA sequencing, which allows scientists to look at tiny numbers of cells and their structure with unprecedented detail.

Meanwhile the London patient will continue to be monitored for any signs of remission, but most agree he is “functionally cured” of HIV.

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