What is HIV Remission? What Does this Mean for a Cure?

The word “remission” springs from the verb “to remit”. Remission means the ability to leave a disease-free lifestyle having stopped taking treatment. Therefore, the term “HIV Remission” is used to describe a situation when someone after receiving treatments tailored to cure the virus and is very healthy, lives his normal life again. That is where the question now arises: is it possible for a patient to undergo a successful HIV treatment? Though there is no cure for HIV the disease can go into ‘remission’, so to speak. During this period, the virus is made to be under intense suppression for a long period of time by the immune system without the use of ARV (abbreviation for antiretroviral). This case of HIV remission has now been reported for the second time — a man known as “London Patient” has been engaging in his daily activities after successful treatment. This patient has been effectively cured of the disease following a stem transplant. It is now the 18th month after having passed a successful treatment of the disease without ARV. According to the study lead author, Dr. Ravindra Gupta — a professor at the University College of London and an HIV biologist who was involved in the — there is no sign of virus after treatment but they cannot technically conclude now that he has been fully cured; he still needs to be placed under careful examination. He said: “Finding a way to eliminate the virus entirely is an urgent global priority, but is practically difficult because the virus integrates into the white blood cells of its host.” “London Patient” Is the Second-Known Patient to Have Had an HIV Remission This is the second case of HIV remission reported. The first was Timothy Brown (aka Berlin patient). Timothy Brown was tested positive for HIV in 1995. Afterward, he started to undergo ART but was still living with the virus. In addition, after some years of living with the virus, Brown faced another health crisis — this time around, a cancer of the blood, Leukemia. In order for Brown to survive this ordeal, he needed, according to the senior doctor, to undergo a Stem Cell Transplant — a treatment which helps to replace the unhealthy blood cells in the body with normal blood cells. The doctors suggested that Brown needed a type of donor whose genes can make the immune cells that are able to build resistance against HIV. After years of careful examination, Brown has been reported to be cancer-free and has no trace of the virus in his body. After ten years of Brown’s case, there comes the “London patient”. He was diagnosed with HIV infection in 2003 and had been on Antiretroviral therapy since 2012. But later in 2012, this same patient developed Hodgkin’s Lymphoma. As suggested by the doctors, the patient had to undergo chemotherapy, in addition to Stem Cell Transplant. Like Timothy Brown, the London Patient received stem cell transplant from a donor with the rare genetic mutation known as CCR5 delta 32’. Chemotherapy was used in the two patients because it is very effective in combating HIV as it kills cells that are separating. CCR5 is the most commonly used receptor by HIV-1 patients who have two mutated copies of the CCR5 alleles. This mutation, CCR5 delta 32’, prevents the virus from using CCR5 as a receptor to enter the host’s cells. Will There Be A Permanent Cure for HIV? With this height attained by medical doctors, other medical doctors believe that replacing the host’s immune cells with those of the donor’s has proven to be an effective way of preventing the HIV disease from re-occurring, thus helping the patient to be on remission. However successful the two treatments were for both men, there are still some complications. Both the Berlin and London patients experienced some pains — graft-versus-host disease — a disease which occurs when the donor’s immune cells attack the recipient’s.  As believed by doctors, this graft-versus-host disease also played a role in the disappearance of the virus. This report was presented on March the 5th at the annual Conference on Retroviruses and Opportunistic Infections (CROI) in Seattle. Although they can’t say that this is the best treatment so far, they are sure that more researches for the treatment which is absolutely capable to cure the disease totally are being carried out.

However, it is advised that you keep taking your medications if you are an HIV patient.

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