UK patient 'free' of HIV after stem cell treatment
Second case of its kind in the world
London, Mar 5: A UK-based male patient's HIV has become "undetectable" following a stem cell transplant in only the second case of its kind in the world, scientists led by an Indian-origin researcher reported Tuesday in a study published in the journal Nature.
The 'London patient', who has not been named, was diagnosed with HIV in 2003 and advanced Hodgkin's lymphoma in 2012.
Professor Ravindra Gupta said the patient was treated with stem cell transplants from donors carrying a genetic mutation that prevents expression of an HIV receptor CCR5.
The subject of the new study has been in remission for 18 months after his antiretroviral therapy (ARV) was discontinued, he said.
"At the moment the only way to treat HIV is with medications that suppress the virus, which people need to take for their entire lives, posing a particular challenge in developing countries," said Gupta from University College London (UCL), the study's lead author
"Finding a way to eliminate the virus entirely is an urgent global priority, but is particularly difficult because the virus integrates into the white blood cells of its host," he said in a statement.
The team, which comprised of researchers at UCL and Imperial College London as well as partners at the University of Cambridge and the University of Oxford, said the latest case is a proof of the concept that scientists will one day be able to end AIDS, caused by HIV, but does not mean a cure for HIV has been found.
The case report comes 10 years after the first such case known as the "Berlin Patient".
"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," said Gupta.
"Continuing our research, we need to understand if we could knock out this receptor in people with HIV, which may be possible with gene therapy," he added.
Close to 37 million people are living with HIV worldwide, but only 59 per cent are receiving ARV, and drug-resistant HIV is a growing concern.
Almost one million people die annually from HIV-related causes, researchers said.
The report describes a male patient in the UK, who prefers to remain anonymous, and was diagnosed with HIV infection in 2003 and on antiretroviral therapy since 2012.
In 2012, he was diagnosed with advanced Hodgkin's Lymphoma. In addition to chemotherapy, he underwent a haematopoietic stem cell transplant from a donor with two copies of the CCR5 allele in 2016.
CCR5 is the most commonly used receptor by HIV-1. People who have two mutated copies of the CCR5 allele are resistant to the HIV-1 virus strain that uses this receptor, as the virus cannot enter host cells.
Chemotherapy can be effective against HIV as it kills cells that are dividing. Replacing immune cells with those that do not have the CCR5 receptor appears to be key in preventing HIV from rebounding after the treatment.
The transplant was relatively uncomplicated, but with some side effects including mild graft-versus-host disease, a complication of transplants wherein the donor immune cells attack the recipient's immune cells.
The patient remained on ARV for 16 months after the transplant, at which point the clinical team and the patient decided to interrupt ARV therapy to test if the patient was truly in HIV-1 remission.
Regular testing confirmed that the patient's viral load remained undetectable, and he has been in remission for 18 months since ceasing ARV therapy (35 months post-transplant).
The patient's immune cells remain unable to express the CCR5 receptor. He is only the second person documented to be in sustained remission without ARV, the researchers said.
The first, the Berlin Patient, also received a stem cell transplant from a donor with two CCR5 alleles, but to treat leukaemia.
Notable differences were that the Berlin Patient was given two transplants, and underwent total body irradiation, while the UK patient received just one transplant and less intensive chemotherapy.
Both patients experienced mild graft-versus-host disease, which may also have played a role in the loss of HIV-infected cells.
The researchers caution that the approach is not appropriate as a standard HIV treatment due to the toxicity of chemotherapy, but it offers hope for new treatment strategies that might eliminate HIV altogether.
"The treatment we used was different from that used on the Berlin Patient, because it did not involve radiotherapy. Its effectiveness underlines the importance of developing new strategies based on preventing CCR5 expression, said co-author Ian Gabriel, of the Imperial College NHS Trust.
"While it is too early to say with certainty that our patient is now cured of HIV, and doctors will continue to monitor his condition, the apparent success of haematopoietic stem cell transplantation offers hope in the search for a long-awaited cure for HIV/AIDS," added Professor Eduardo Olavarria, from Imperial College London.
The team is presenting the findings at the annual Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle, US this week.
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Jharkhand horror: Man kills live-in partner, chops body into 40 pieces
Ranchi (PTI): A 25-year-old man, who works as a butcher, allegedly strangled to death his live-in partner and chopped her body into 40 to 50 pieces in a forested area in Jharkhand’s Khunti district, police said on Wednesday.
The accused, identified as Naresh Bhengra, was arrested.
The matter came to light after around a fortnight after the killing when a stray dog was found with human body parts near Jordag village in Jariagarh police station on November 24.
Bhengra was in a live-in relationship with the deceased, a 24-year-old woman also from Khunti district, in Tamil Nadu for the past couple of years. Sometime back, he returned to Jharkhand, got married to another woman without telling his partner anything and went back to the southern state without his wife to join her.
"The brutal incident occurred on November 8 when they reached Khunti as the accused who had married another woman did not wish to take her home. Instead, he took her to a forest near his house at Jordag village in Jariagarh police station and chopped the body into pieces. The man has been arrested," Khunti Superintendent of Police Aman Kumar told PTI.
Inspector Ashok Singh who investigated the case said the man worked in a butcher shop in Tamil Nadu and was expert in slicing chicken.
“He admitted chopping the body parts of the woman into 40 to 50 pieces before leaving those in the forest for wild animals to feast on. The police recovered several parts on November 24 after a dog in the area was seen with a hand," Singh told PTI.
Singh said that the woman, who was unaware of his marriage, pressured him to return to Khunti. After reaching Ranchi, they boarded a train on November 24 and headed to the man's village.
"Under a plan, the man took her to Khunti in an autorickshaw near his home and asked her to wait. He returned with sharp weapons and strangulated her with her dupatta after raping her. He then cut the body into 40 to 50 pieces and left for his home to live with his wife," Singh said.
The woman, however, had informed her mother that she had boarded a train and would be living with her partner, the police officer said.
Following the recovery of body parts, a bag was also found in the forest with the murdered woman's belongings including her Aadhaar card. The mother of the woman was called at the spot and she identified her daughter's belongings.
"The mother suspected the man behind the crime who after being nabbed by the police admitted to chopping the woman into pieces," the official added.
The incident has sent shockwaves among people in the region, with the Shraddha Walker murder case of 2022 still fresh in their memory.
Walker was killed by her live-in partner who chopped her body into pieces before dumping them in the jungle in South Delhi’s Mehrauli.
