2nd Man to be Cured of HIV Reveals Identity. Here’s How He Beat It
Explained: Significance of London Patient in the cure for HIV/AIDS
Editor: Kunal Mehra
Camera: Omar Shah
The ‘London patient’, only the second person ever to be cured of HIV, recently went public and revealed his identity as Adam Castillejo, with the aim of also being an ‘ambassador of hope’. In an interview with The New York Times, 40-year-old Castillejo shared that he had been living with HIV since 2003 and was diagnosed with acute myelogenous leukaemia in 2012.
40 million people worldwide live with HIV/AIDS. Currently there is NO cure.
Then came along the Berlin patient in 2007 – the first man to be cured of HIV.
10 years ago people described a person identified as "Berlin Patient" where a patient with HIV who had blood cancer had a complete removal of their blood system and replacement with a donor’s immune system which is called an allogenic stem cell transplantation.
The donor was unique. He had something called a Delta 32 gene mutation that is found in 1 percent of Northern Europeans that protects them from ever getting HIV.
Later, the patient was identified as Timothy Ray Brown.
After undergoing intense radiation, chemotherapy and stem cell transplantation, Brown was declared CURED of HIV. Many attempts were made to replicate the treatment – most failed, prompting some to call the treatment a fluke.
But was it?
FIT spoke with Dr Ravindra Gupta, a scientist who led the team at University College London that was behind the "London Patient," only the second man to be cured of HIV.
We attempted a second cure by finding a donor with this mutation in order to treat one of our patients in London who was suffering from HIV and Lymphoma, which is a type of blood cancer. He needed a blood transfer because all the chemotherapy and drugs had failed, and the alternative was death, so a decision was made to carry out this procedure that carries mortality risk of 10 percent.Dr Ravindra Gupta, University College London
The London patient was diagnosed with HIV in 2003 and 10 years later he developed Lymphoma. But what made the London patient different from the Berlin patient? There where three main differences:
Number 1 was whether you need radiation. The Berlin patient had required two rounds of total body radiation which is a very uncomfortable procedure and has a lot of side effects. In our case we did not use radiation.Dr Ravindra Gupta
"Secondly the kind of chemotherapy drugs we used were much milder. So we realised we don’t need to use such toxic drugs in an individual.
Thirdly, the Berlin patient needed two rounds of chemotherapy because cancer came back quite quickly. So the transplant had to happen a second time. So we answered this question that you actually needed just one good procedure," he adds.
Once the procedure happened, the patient needed to be kept on HIV drugs for a period of time and then show that there was no HIV detectable before those drugs were taken away. He was kept on HIV drugs for 18 months and when extensive tests showed there was no virus, the were withdrawn.
"And then we were watching every week – doing tests every week, and after that it was really just a matter of waiting," Dr Gupta adds.
That wait lasted 18 months and when the HIV didn’t return, it was time to publish the results.
So is the London patient ‘CURED’ of HIV?
Now we have data of upto 23 months and there has been no sign of HIV, we’ve also tested a lot of tissues and we haven’t found any virus so we are now more confident this is a cure.Dr Ravindra Gupta
Exciting as this is, what does it mean for millions of HIV patients? The future, Dr Gupta says, lies in gene editing.
"First of all this is a very dangerous procedure, secondly Delta 32 donors are very rare. There are gene editing approaches that are being used which will mimic the Delta 32 mutations. These are genetic engineering techniques that are being used to treat genetic diseases like hemophilia or other immune conditions. There’s research going on to see if these can be applied to HIV to kind of mimic Delta 32 phenotype," Dr Gupta says.
Like Berlin and London patients, there are 38 more who are being treated using this technique – success of their treatment could lay down the path to a cure for the disease that has taken millions lives.
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