ロンドンの男性、2人目のHIV完治例に
これまで「ロンドンの患者」とのみ知られていた男性は今週、身元を公表し、ベネズエラ出身のアダム・カスティエホさん(40)であることが分かった。
カスティエホさんについては昨年、血液中からHIVが検知されない状態が1年半にわたり続いていることがケンブリッジ大学の研究チームによって発表され、大々的に報じられていた。
論文の主執筆者、ラビンドラ・グプタ氏は、新たな検査結果はこれよりも「さらに素晴らしく」、カスティエホさんの完治を示したものとみられると説明。AFPの取材に対し、「HIVが潜伏することの多い部位を多数検査した結果、活性ウイルスの有無についてはほぼすべて陰性だった」と述べた。
カスティエホさんは2003年にHIV陽性の診断を受け、12年にエイズ発症を抑制する薬剤治療を開始。同年、血液がんの一種であるホジキンリンパ腫が進行していることが判明し、16年に骨髄移植を受けた。
カスティエホさんはこの際、遺伝子変異によってHIVに耐性があるドナーから幹細胞移植を受けた。この遺伝子変異がある人の割合は欧州人で1%未満。
世界ではHIVにより年間100万人近くが死亡している。初のHIV治癒例は「ベルリンの患者」と呼ばれた米国人のティモシー・ブラウンさんで、2011年に類似の治療を受けて完治した。
ただ研究チームは、この治療法がHIV陽性者に広く適用できるものではないと注意を促している。【翻訳編集AFPBBNews】
〔AFP=時事〕(2020/03/13-12:57)
London man second patient to be cured of HIV
A second patient has been cured of HIV after undergoing stem cell transplant treatment, doctors said Tuesday, after finding no trace of infection 30 months after he stopped traditional treatment.
The so-called London Patient, a cancer sufferer originally from Venezuela, made headlines last year when researchers at the University of Cambridge reported they had found no trace of the AIDS-causing virus in his blood for 18 months.
Ravindra Gupta, lead author of the study published in The Lancet HIV, said the new test results were even more remarkable and likely demonstrated the patient was cured.
We've tested a sizeable set of sites that HIV likes to hide in and they are all pretty much negative for an active virus, Gupta told AFP.
The patient, who revealed his identity this week as Adam Castillejo, 40, was diagnosed with HIV in 2003 and had been on medication to keep the disease in check since 2012.
Later that year, he was diagnosed with advanced Hodgkin's Lymphoma, a deadly cancer.
In 2016 he underwent a bone marrow transplant to treat blood cancer, receiving stem cells from donors with a genetic mutation present in less than one percent of Europeans that prevents HIV from taking hold.
He becomes only the second person to be cured of HIV after American Timothy Brown, known as the Berlin Patient, recovered from HIV in 2011 following similar treatment.
Viral tests of Castillejo's cerebral fluid, intestinal tissue and lymphoid tissue more than two years after stopping antiretroviral treatment showed no active infection.
Gupta said the tests uncovered HIV fossils -- fragments of the virus that were now incapable of reproducing, and were therefore safe.
We'd expect that, he said.
It's quite hard to imagine that all trace of a virus that infects billions of cells was eliminated from the body.
- Ethical dilemma -
Researchers cautioned that the breakthrough did not constitute a generalised cure for HIV, which leads to nearly one million deaths every year.
Castillejo's treatment was a last resort as his blood cancer would likely have killed him without intervention, according to Gupta.
The Cambridge doctor said that there were several other patients who had undergone similar treatment but who were less far along in their remission.
There will probably be more but they will take time, he said.
Researchers are currently weighing up whether or not patients suffering from drug-resistant forms of HIV might be eligible for stem cell transplants in future, something Gupta said would require careful ethical consideration.
You'd have to weigh up the fact that there's a 10-percent mortality rate from doing a stem-cell transplant against what the risk of death would be if we did nothing, he said.
Commenting on The Lancet study, Sharon Lewin, an infectious disease expert at the University of Melbourne, said the findings could provide comfort to patients.
But she advised caution.
Given the large number of cells sampled here and the absence of any intact virus, is the London patient cured? she said.
Unfortunately in the end, only time will tell.
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