The treatment that cured two H.I.V. cases won't work for most patients.

Pedro_P

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What a second H.I.V. remission means—and what it doesn't.

This is a big breakthrough—but it's far from becoming standard treatment.
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▼ For the second time, doctors are reporting that a patient’s HIV has gone into sustained remission following a stem cell transplant—leaving him effectively cured of the disease.
The patient had Hodgkin’s lymphoma, and underwent a stem cell transplant to replace his cancerous white blood cells with healthy ones. The donor had a genetic mutation that prevents H.I.V. from being able to infect cells. Just under a year and half after the transplant, the patient stopped taking the antiretroviral drugs that control H.I.V. infection, and 18 months after later, he remains H.I.V. free. The case study was published today in *Nature*.
A stem cell transplant is the same method that led to sustained H.I.V. remission in Timothy Ray Brown, referred to as the Berlin patient, 12 years ago.
“This tells us that Timothy Ray Brown’s case can be recreated,” says Timothy Henrich, associate professor of medicine and H.I.V researcher at the University of California San Francisco. “The Berlin patient showed us that sustaining long-term, HIV-free viral remission is possible. It was certainly a momentous case. It really invigorated and excited the community to look at alternative approaches, and gene therapy.”
The new case does not necessarily offer new insights into H.I.V., he says, but offers important confirmation of the initial work. “Two is better than one.”
In the new case and in the Berlin patient, the H.I.V. virus relied on a receptor called CCR5 to enter and infect cells. Both patients had transplants from donors whose cells lacked that particular receptor, and when the donor cells took over, the virus couldn’t infect them. “The original Berlin patient told us that if you have cells that lack that co-receptor, you’re essentially providing a huge pool of cells that cannot become infected,” Henrich says.
While the new report is exciting, both for the H.I.V. research community and the patient, this approach to treating H.I.V isn’t scalable. (▪ ▪ ▪)

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mazherali

So people who have a mutation leading to absence of CCR5 receptor are resistant to HIV infection. A future target for gene therapy.