Third Patient Cured of HIV

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    In News

    • The journal Nature Medicine has recently released about a patient being cured of AIDS.

    About

    • A 53-year-old German man is the third person to be “cured” of HIV after undergoing a bone-marrow transplant from an HIV-resistant donor.
    • The transplant was performed for blood cancer treatment, and the HIV virus was undetectable in his body even four years after he stopped taking antiretroviral medicine.
    • The patient received a stem cell transplant from a female donor with a rare mutation in her CCR5 gene, which stops HIV from entering cells.
    • The bone marrow transplant used in this case is a severe and dangerous operation, and it is only suitable for some special cases or a small number of patients suffering from HIV and blood cancer.
    • According to the study, this case of HIV-1 cure” provides “valuable insights that will hopefully guide future cure strategies,”

    What is CCR5-Delta 32 Mutation?

    • It is found in 1% of the population, and it prevents the CCR5 receptors on CD4 immune cells, which act as a doorway for the HIV virus, from forming on the surface.
    • People with two copies of the mutation are almost immune to HIV, while those with one copy are less likely to contract the virus.

    Can Bone-Marrow Transplants Solve the HIV Crisis?

    • The mutation occurs mainly among Caucasians, making it difficult to find a matching donor, especially for those from countries with high HIV burden.
    • Bone-marrow transplants are a risky and complex procedure, and it is unlikely to be rolled out for all those with HIV.
      • A bone marrow transplant is a medical treatment that replaces one’s bone marrow with healthy cells. The replacement cells can either come from the person’s own body or from a donor.
      • A bone marrow transplant is also called a stem cell transplant or, more specifically, a hematopoietic stem cell transplant.
    • The virus may mutate and enter cells through other mechanisms, making the cure ineffective.

    Stem cells 

    • Stem cells are undifferentiated, or “blank,” cells. This means they’re capable of developing into cells that serve numerous functions in different parts of the body.
      • They can divide over and over again to produce new cells.
      • As they divide, they can change into the other types of cell that make up the body.

    Types of Stem Cells

    • Stem cells are divided into 2 main forms. They are embryonic stem cells and adult stem cells.
    • Embryonic stem cells: The embryonic stem cells used in research today come from unused embryos. These result from an in vitro fertilization procedure. They are donated to science. These embryonic stem cells are pluripotent. This means that they can turn into more than one type of cell.
    • Adult stem cells: There are 2 types of adult stem cells. 
      • One type comes from fully developed tissues such as the brain, skin, and bone marrow. There are only small numbers of stem cells in these tissues. They are more likely to generate only certain types of cells. For example, a stem cell that comes from the liver will only make more liver cells.
      • The second type is induced pluripotent stem cells. These are adult stem cells that have been changed in a lab to be more like embryonic stem cells. Induced pluripotent stem cells don’t seem to be different from embryonic stem cells, but scientists have not yet found one that can develop every kind of cell and tissue.

    What is AIDS?

    • AIDS stands for Acquired Immunodeficiency Syndrome, which is a chronic, potentially fatal condition caused by the Human Immunodeficiency Virus (HIV).

    Causes:

    • HIV is a virus that attacks the immune system, specifically the CD4 cells, which are crucial for fighting off infections.
    • It primarily spread through unprotected sexual contact, sharing needles or syringes, and from mother to child during pregnancy, childbirth, or breastfeeding.

    Symptoms:

    • Many people with HIV do not experience any symptoms for years after infection, but the virus continues to damage the immune system.

    • As HIV progresses, symptoms may include fever, fatigue, weight loss, night sweats, swollen lymph nodes, and recurrent infections.

    Treatment:

    • At present, there is currently no cure for HIV or AIDS, but antiretroviral therapy (ART) can slow the progression of the virus and improve quality of life.
    • It involves taking a combination of medications that target different stages of the virus’s life cycle, reducing its ability to replicate and damage the immune system.
    • The drugs have to be taken for life because the virus continues to persist in reservoirs across the body.
    • If left untreated, the virus destroys a person’s immune system and leads to AIDS resulting in death.

    HIV Facts & Figures: 

    • AIDS Society of India, India has the third-highest HIV burden with 2.35 million.
    • In 2019, there were 69,220 new HIV infections and 58,960 AIDS-related deaths in India. 
    • UNAIDS Report 2020, Asia Pacific region saw a 12% decline in new HIV infections and a 29% decline in AIDS-related deaths over the last decade.

    Government steps to control:

    • India has implemented various schemes and programs to control and eradicate AIDS in the country.
    • National AIDS Control Programme (NACP): It is a comprehensive program launched in 1992 to control the spread of HIV/AIDS in India by promoting safe behavior, increasing awareness, and providing counselling and testing services.
    • Targeted Interventions (TI): Under the NACP, TI is a program that targets high-risk groups such as sex workers, injecting drug users, and men who have sex with men.
    • Antiretroviral Therapy (ART): The government provides free ART to all HIV-positive patients in the country besides providing free diagnostic tests and treatment for opportunistic infections associated with HIV.
    • 90:90:90 strategy as adopted by UNAIDS (90% (diagnosed, treatment (by anti-retroviral treatment (ART)) & suppression)) by 2020.
      • Extended by 10 years with the goal post of 95-95-95.
    • Community-based approaches: The government also involves local communities, civil society organizations, and people living with HIV/AIDS in the planning, implementation, and monitoring process to tackle HIV/AIDS.
    • Jan Jagriti Abhiyan: This is a mass awareness campaign launched by the government to educate people about HIV/AIDS especially in rural areas and promote safe behavior and practices.
    • National Rural Health Mission (NRHM): It was launched by the government to provide primary healthcare services to people living in rural areas.

    Did you know?
    • Timothy Ray Brown, the Berlin patient, was the first person to overcome HIV after receiving two stem cell transplants in 2007 and 2008. The donor carried two copies of a CCR5-delta 32 genetic mutation.
    • The London patient, Adam Castillejo, also underwent a transplant from an HIV-resistant donor for blood cancer treatment, and the virus remained undetectable in his body after the transplant.

    Conclusion

    • While bone-marrow transplants offer a cure for HIV, they are not a viable option for everyone.
    • Antiretroviral therapy remains the most effective treatment for managing HIV and preventing the transmission of the virus.

    Source: IE

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