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VIDEO

The London Patient: Not a "Cure" Just Yet

MAR 12, 2019 | CONTAGION® EDITORIAL STAFF

Segment Description: Laura Waters, MD, FRCP, a consultant physician in the GU and HIV Division at Mortimer Market Center, and an author on the Nature article on the reported HIV remission of the London Patient, explains why it is too soon to label the remission as a cure.

Interview transcript (modified slightly for readability):

The London Patient was very big news. It was big news before the conference because there was some kind of journalistic lack of embargo respect, as far as I understand. But, this is now the second reported case after the Berlin Patient, published 10 years ago, in somebody who's undergone a stem-cell transplant or a bone marrow transplant for some kind of malignancy.

So, the London Patient is somebody who had a lymphoma, who underwent stem cell transplantation, and they chose a bone marrow, or stem cell donor, with the Delta 32 mutation and they were homozygous for that mutation. What that means is you are pretty, not entirely, but pretty resistant to HIV if you've got that mutation so by replacing the patient cells with these resistant cells basically it's been ‘cured of HIV.’ Now, I say cure with inverted commas because it's far too early to say ‘cure.’ This is a case of long term remission he's been off treatment for 18 months, but that's really not long enough yet.

I think it's been an awful lot of excitement a lot of stuff in the general media. But, I think actually the reaction from the community has been the most realistic in that yes, this is great, it’s testing the science, it's proving that the Berlin Patient wasn't a one-off case. But, this is a really dangerous treatment with a high mortality rate and lots of side effects and it's not one that's ever going to be rolled out across the HIV population.

So, yes, it's good, yes, it's interesting, it suggests CCR5 as a target for therapeutic options in the future is a viable target, but, we've got to be more realistic. With the United States having 60% viral suppression rates overall, I think there are some more basics we should be focusing on rather than getting too carried away with the cure stories.
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