A 40-YEAR-OLD from London has become the second person in the world to be "cured" of HIV following a high-risk stem cell transplant.
The case reported in the Lancet today comes after the man revealed his identity for the first time.
Adam Castillejo, the so-called 'London patient', was previously declared free of HIV 18 months after stopping antiretroviral therapy following a stem cell – or bone marrow – transplant to treat blood cancer.
Now a follow-up study has confirmed that the virus remains undetectable 30 months after treatment.
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The findings are being shared today at the annual Conference on Retroviruses and Opportunistic Infections, which is being held virtually this year to prevent coronavirus spread.
Mr Castillejo is only the second person in the world to be declared HIV-free following the procedure.
The first was "Berlin Patient" Timothy Ray Brown, whose HIV was eliminated following a bone marrow transplant in 2007.
Speaking to the New York Times on Monday - ahead of the results being published - Venezuelan-born Mr Castillejo said he wanted to go public so that his experience could be a cause for optimism.
He said: “This is a unique position to be in, a unique and very humbling position.
"I want to be an ambassador of hope.”
Mr Castillejo underwent a stem cell transplantation in May 2016 from donors with an HIV-resistant gene.
Tests at 30 months revealed there was no active viral infection in his blood, semen, or spinal fluid, although remnants of integrated HIV-1 DNA remained in intestinal and lymphoid tissue samples.
The authors suggest that these can be regarded as "fossils" since they are unlikely to be capable of reproducing the virus.
Mr Castillejo also had a healthy count of CD4 white blood cells, a key indicator that the immune system is functioning properly.
Furthermore, 99% of the Mr Castillejo's immune cells were derived from the donor’s stem cells, indicating the stem-cell transplant had been successful.
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Lead author on the study, Professor Ravindra Kumar Gupta, of Cambridge University, said: “We propose that these results represent the second ever case of a patient to be cured of HIV.
"Our findings show that the success of stem cell transplantation as a cure for HIV, first reported nine years ago in the Berlin patient, can be replicated.”
He added: “It is important to note that this curative treatment is high-risk, and only used as a last resort for patients with HIV who also have life-threatening haematological malignancies.
"Therefore, this is not a treatment that would be offered widely to patients with HIV who are on successful antiretroviral treatment."
Mr Castillejo was first diagnosed with HIV 2003 and was told he was terminally ill with stage four Hodgkin lymphoma - a form of blood cancer - in 2012.
He underwent one round of stem-cell transplantation from a donor who carries a version of the CCR5 gene, known to be resistant to HIV.
He also had a chemotherapy with a reduced-intensity drug regimen.
The therapy was less intensive than that given to 'Berlin patient' Mr Ray who had two stem cell transplants and whole-body radiation in addition to chemotherapy.
The authors said this represents a step towards a less intensive treatment approach, although the procedure is invasive and risky because it increases patients' chances of contracting serious infections.
Drug advances mean people with HIV can live a normal, healthy life by taking a pill to dramatically reduce their levels of the virus and prevent its transmission.
Mr Castillejo will still require monitoring for signs of the virus re-emerging.
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