Eye on France: Second HIV remission raises hopes in fight against killer disease

A second HIV-positive patient appears to have recovered from the virus which causes Aids. This has happened only once before, with the two cases separated by nearly a decade. Medical scientists have greeted the news as proof that the first case was not a bizarre mistake.

Hope for sufferers: will anti-Aids protests become a thing of the past? REUTERS/Rupak De Chowdhuri

The latest “recovery” suggests that a cure for the fatal infection can, eventually, be found.

According to the magazine Nature, followed by the French dailies Le Monde and Le Figaro, this second sufferer has been completely free of the virus for the past 19 months, despite having stopped all treatment. Researchers are describing him as “probably” cured.

What the two cases – the first in Berlin, this latest one in London – have in common is that both patients received bone-marrow transplants to help treat cancer.

The transplants came from donors who have a rare genetic make-up which prevents the HIV virus from invading healthy cells.

The details were to be revealed later at conference on viral infections in Seattle.

Millions of Aids sufferers worldwide control the virus and live virtually normal lives thanks to a cocktail of drugs. But they continue to carry HIV.

Of the 37 million carriers of the virus, only 60 percent have access to proper treatment. The rest are too poor, too isolated or too weak to benefit from the medical advances that could keep them alive.

At least one million people die every year from Aids-related illnesses, most of the victims in the so-called developing world.

And doctors are now starting to worry about the emergence of a drug-resistant form of the virus.

Which makes the existence of this second “cured” patient so important.

Transplants are not the magical answer

Doctors are stressing that bone-marrow transplants are not, themselves, the answer. It’s a dangerous, expensive and painful procedure.

But this second case should enable researchers to fine tune their efforts and reduce the number of approaches to treatment which are being investigated.

The aim is to find a way of completely eliminating the virus, without also killing the crucial white blood cells which it penetrates.

The latest remission concerns an anonymous patient who was first diagnosed HIV-positive in 2003. He had been on anti-retroviral treatment since 2012. Then he got Hodgkin’s disease, a cancer which attacks white blood cells and causes swelling of glands in the neck, armpits and groin.

He was given bone-marrow transplants as part of the treatment for the cancer. And the donor was one of the rare human beings to have a mutated gene known as CCR5. Less than one percent of the global population has the mutation. CCR5 is important because it is one of the genes most frequently used by HIV as a way into healthy cells. The mutated form of CCR5 resists infection, and so protects the carrier (or the lucky recipient) from Aids.

The so-called London patient continued taking anti-retrovirals for 16 months after the transplant, then he stopped completely. He has been HIV-free ever since.

The current health and HIV-status of the earlier patient, from Berlin, is not given by any of the articles in today’s French papers. Which is a pity.

France needs better statistics to fight Aids

Left-leaning daily Libération takes the opening of the Seattle Aids conference as the opportunity for a look at current situation in France.

"Not great" is the headline summary, with a crucial lack of statistics on new infections. Libé says that the French Public Health Agency will publish its most up-to-date figures later this month...which will cover the situation back in 2017.

And this despite the fact that there is a computer system for registering HIV-positive patients, which is supposed to obligatory for all doctors. Except that all doctors and several major public hospitals don’t have the card reader necessary to allow access to the system. So about half of them don’t bother.

Libération says that, without any reliable statistics to prove otherwise, new infections in France are probably running at the rate of 6,000 every year.

But crucial policy decisions are taken on the basis of these obviously inaccurate numbers. And how can you evaluate the usefulness of a particular initiative if you can’t count the number of people helped by it?

That’s been the case, for example, with the after-risk treatments available for the past 15 years, or the effort to get those at risk identified and treated as soon as possible after exposure. The impact of both of these efforts has been masked by the simple absence of statistical results. They could be working very well, but nobody knows for sure.

Libé says it is lamentable that, 37 years after the first Aids case was reported in France, public health decisions are still being made on the basis of approximations. And old approximations at that.