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Updated On: Monday, 20 May 2019

AIDS success ‘unworkable’ for vast majority

Medical experts hailed the news this week that a second HIV-positive man appears to have eliminated the virus from his body, but warned the treatment used is completely unviable for the vast majority of the 37 million people living with the disease.

AIDS, caused by infection with the human immunodeficiency virus (HIV) virus, is one of the three big diseases affecting people in the developing world along with tuberculosis and malaria. Around a million people died from AIDS-related illnesses in 2017. Researchers from University College London (UCL) reported 5 March in the journal Nature the case of an HIV-positive man who, after receiving a bone marrow transplant, no longer showed any sign of the AIDS virus, 18 months after he had stopped taking antiretroviral therapy. Presenting their work on the same day at the annual conference on retroviruses and opportunistic infections in Seattle, USA, the researchers said they used largely the same method which had been used in 2007 in Berlin on Timothy Ray Brown.

“Even reaching a very limited number of people to achieve ‘near-cure’ of HIV infection is a welcome achievement. It still seemed utopian a decade ago.”

Avelin Aghokeng

The so-called “Berlin patient” is considered the first person in the world to have been cured of HIV/AIDS, as the virus has not been detected in his body since then. It is this gene that causes the AIDS virus to penetrate the immune cells and multiply. But the mutation prevents the virus from entering and taking hold. As a stem cell, the transplanted bone marrow will produce new immune cells containing the mutated CCR5 gene which will gradually replace the old cells, blocking the virus, which can no longer replicate.
Eric Delaporte, head of the laboratory for translational research on HIV and infectious diseases at the Institute of Research for Development (IRD), in France, says the rare genetic mutation is only found in one per cent of the population.
"As is often the case with AIDS, we are dealing with an overrepresentation of a result where we speak of ‘healing’, when in practice, for the millions of people living with HIV, this is not the solution," he tells SciDev.Net.

‘False hope’

Delaporte also finds the process "complicated and dangerous". "You have to put the patient in aplasia, that is, destroy the cells with chemotherapy and then transplant the marrow of a compatible donor," he says. For Delaporte, the excitement around the story gives "false hope". “Although this breakthrough is complicated and much more work is needed, it gives us great hope for the future that we could potentially end AIDS with science, through a vaccine or a cure,” he wrote in a press release issued by the organisation. "Even reaching a very limited number of people to achieve ‘near-cure’ of HIV infection is a welcome achievement. It still seemed utopian a decade ago," he says.
“Advances in research are enriched by such proofs of concept and open up new avenues for research and intervention.”

‘Proof of concept’

“Although it is not a viable large-scale strategy. these new findings reaffirm our belief that there exists a proof of concept that HIV is curable,” says Anton Pozniak, president of the International AIDS Society (ISA). The British infectious disease specialist said he hoped “that this will eventually lead to a safe, cost-effective and easy strategy to achieve these results using gene technology or antibody techniques. The authors of the work prefer to focus on the potential for the scientific community. "It also helps to better control the approach, its benefits and also its limitations and dangers. It should be noted that behind this success are also many failures of this approach.”
This piece was produced by SciDev.Net’s Sub-Saharan Africa French desk.

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