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Top HIV doctor says 'London Patient' cure 'too risky' to be feasible treatment

Dr. Anthony Fauci said that the real "big breakthrough" is modern antiretroviral treatments, which are safe, effective and render a person uninfectious.
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Dr. Anthony Fauci, one of the nation's top HIV/AIDS doctors, cautioned that the highly publicized case of the so-called London Patient — the second person in the world confirmed to be cured of HIV infection — does not mean a widely available cure is on the horizon anytime soon.

"To think that bone marrow transplantation is going to be a scalable, feasible, safe way to treat infections is really, unfortunately, misleading, because it is not," Fauci, director of the National Institute for Allergy and Infectious Disease, said Tuesday on MSNBC.

The 'London Patient' was cured of HIV in the process of being treated for a much deadlier disease: Hodgkin's Lymphoma. This cancer of the lymphatic system can be treated with a risky bone marrow transplant from a donor whose marrow matches. "This was really his last chance of survival," Dr. Ravindra Gupta, the patient's doctor, told Reuters.

As was the case for the "Berlin Patient," the first person to be cured of HIV, the "London Patient's" marrow donor happened to have a genetic mutation called CCR5 delta 32, which occurs in roughly 10 percent of Europeans and greatly reduces the chance of HIV infection.

"If we can find a safe, scalable way to modify [the CCR5 receptor] in someone without putting them through the very risky procedure of a bone marrow [transplant], then that would be very important for looking ahead about the possibility of cure," Fauci explained.

Until then, however, Fauci said that the current HIV treatment regimen — powerful, antiretroviral medications like Stribild and Juluca — are likely to remain the main treatment for HIV infection for the foreseeable future.

"Today we have such exquisitely effective drugs that if a person has HIV infection, we can give them one pill a day that contains three drugs that, in the majority of people, will drop the virus to completely below detectable level," Fauci said. "The person can lead essentially a normal life and will not infect anyone else. That is the big breakthrough."

Fauci, who is helping to lead a national plan for ending new HIV infections by 2030, said what is important at present is connecting more people living with HIV to antiretroviral treatment. "What we need to do is get access to therapy for people who don't have access," he said.

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