The second person in the world to be cured of HIV has gone public with his identity.
In March 2019, doctors announced that the man, known as the “London patient”, was clear of the virus.
Adam Castillejo, 40, achieved “sustained remission” from HIV after treatment at Hammersmith Hospital last year – more than a decade after the only other cured case was identified in Berlin in 2007.
In a statement, he said: “By publicly revealing my identity and my story, I hope to help improve people’s understanding of the science and HIV generally.
“I want to thank all those who have supported me on this journey, particularly my medical team at Hammersmith Hospital without whom I would not be here today.”
Mr Castillejo, who grew up in Venezuela, was diagnosed with HIV in 2003 after moving to London a year earlier and developed advanced Hodgkin lymphoma in 2012.
In 2016, to fight the rare cancer, he received bone marrow stem cells from a donor with a rare genetic mutation that resists HIV infection.
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Image: Timothy Ray Brown was the fist person to be cured of HIV
HIV patients rely on life-long daily medication to suppress the virus, and when the drugs are stopped it usually comes back within two to three weeks.
But since antiretroviral drugs were discontinued, researchers say Mr Castillejo has been in remission for 30 months “with no viable virus in bloods, brain fluid, intestinal or lymph tissue”.
Remnants of the virus DNA were found in tissue samples, but experts say they are unlikely to cause any problems.
Mr Castillejo, who works in the hospitality industry, said he is “very proud” to consider himself a Londoner.
He was head chef in a corporate dining room when he was diagnosed with cancer, while working a second job on weekends to save money for travel.
“After a couple of years, the chemo became too intense and I could no longer continue to work,’ he added.
“My life fell apart at that stage. I lost my job and I couldn’t afford my flat, so lost that too.
“I am now starting again, rebuilding my life as I steadily get stronger. The journey has given me the chance to gain more knowledge and understanding about cancer research and the world beyond me.
“Now, I am looking forward to building a new path as an ‘Ambassador of Hope’ for millions of people around the world living with HIV.
“Whilst my treatment is not possible for all, I hope it will offer scientists insights that can help us on the journey to better treatment and a cure.”
Stem cell transplants are known to be hard on the body, starting with radiation or chemotherapy to damage the existing immune system and make room for a new one.
The failure rate of such transplants is high.
Professor Ravindra Kumar Gupta, a virologist at the University of Cambridge and lead author on the study, reiterated that the treatment was not suitable for all.
He said: “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 underwent one stem-cell transplantation and a reduced-intensity chemotherapy drug regimen, without whole body irradiation.
Timothy Ray Brown, 54, from the US, and know as the “Berlin Patient”, was the first person to have been cured of HIV after being treated in the German capital 13 years ago. He remains free of the virus.
His therapy included two rounds of stem cell transplant, as well as a total body irradiation and a chemotherapy drug regimen to target any residual HIV virus.
The authors said that while Mr Castillejo’s case represents “a step towards a less intensive treatment approach”, he will need to be monitored in case the virus returns.
Commenting on the research, published in The Lancet HIV journal, Dr Andrew Freedman, reader in infectious diseases and honorary consultant physician from Cardiff University, said: “Although further longer term follow-up will be required, it does seem highly likely that this is the second ever patient to be cured of HIV, after the ‘Berlin patient’.
“As the authors state, such treatment is not suitable for the millions of people infected worldwide.
“They need to continue long term antiretroviral drug therapy which is highly effective in reducing morbidity and mortality, as well as preventing onward transmission.”
On 10 March, a follow-up report on Mr Castillejo’s case will be presented by Professor Ravindra Gupta at this year’s Conference on Retroviruses and Opportunistic Infections (CROI) in Boston, USA – where the “London patient” will share his story.
Source : Sky News