'London patient' cured of HIV reveals identity for the first time

'London patient' cured of HIV reveals identity for the first time

Adam Castillejo was known until recently as the "London patient".

A man in London has become the second person to be ever cured of HIV after undergoing stem cell transplant treatment.

Two days before the conference was set to open in Boston, organizers decided to make the meeting virtual due to concerns about the coronavirus.

Now, writing in the journal Lancet HIV, researchers say that 30 months after stopping antiretroviral drugs - medications that suppress HIV - and 46 months since the transplant, Castillejo remains in remission. He has been HIV-free for more than a decade now.

"After 2.5 years off antiretrovirals and lack of evidence for any active virus, this nearly certainly represents cure", Gupta told the Bay Area Reporter. Adam Castillejo - the now 40-year-old "London patient" who has chose to make his identity public - has no detectable active HIV infection in blood, sperm or tissue, according to his doctors.

Castillejo first found out that he had HIV in 2003, when he was only 23 years old. He is now leading a healthy and active life. He added that he wants to be an ambassador of hope. According to the Times story, he spoke with Brown repeatedly before deciding to reveal his identity.

The donors had an uncommon gene that gives them protection from the virus. Such transplants are risky, and both Castillejo and Brown needed the transplants to treat cancer, rather than for HIV.

HIV, or the human immunodeficiency viruses, lead to AIDS over time, which in turn cause immune system failure.

The other cured HIV patient is known as the "Berlin Patient" and has been off ART therapy for 13 years with undetectable plasma HIV RNA.

In 2011, Castillejo found out that he had been diagnosed with stage 4 lymphoma. The procedure involves the transplantation of multipotent stem cells usually derived from bone marrow, peripheral blood or umbilical cord blood. But he received less aggressive chemotherapy than Brown and was able to stay on antiretroviral therapy. "Most HIV needs to attach itself to the CD4 receptor and the CD5 receptor to get into the cell and become infected", Ragonnet-Cronin tells Dazed, "but some people have a mutation in their CCR5 receptor called Delta 32, which means it's really hard for HIV to attach itself to the cell". In September 2017, with no evidence of viable HIV in his blood, he stopped his antiretrovirals in a closely monitored analytic treatment interruption. "Intestinal lymphoid tissue is an important HIV reservoir and HIV-1 DNA was negative in gut biopsy samples". T cells or macrophages that don't express CCR5 are protected from infection with strains of HIV that use that receptor.

His treatment included two rounds of stem cell transplant, as well as a total body irradiation and a chemotherapy drug regimen to target any residual HIV virus.

In an accompanying comment, Jennifer Zerbato, PhD, and Sharon Lewin, MD, PhD, both of the University of Melbourne in Australia, noted two important points: namely that the low levels of HIV DNA were found "not intact, consistent with archival fragments that can not replicate" and that based on a mathematical model, Gupta and colleagues calculated that the patient had "greater than 90% chimerism in circulating T cells", thus "the chance of future viral rebound while off ART [antiretroviral therapy] is negligible".

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