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Second Man Cured of HIV Confirmed

by Kilian Melloy

EDGE Staff Reporter

Monday March 9, 2020

The world was given a jolt of hope when, in 2010, the news broke that a Berlin man had apparently been cured of HIV after a bone marrow transplant he received in the course of cancer treatment.

The hope that flared from that news was brief, however, given that the case was a rare one, hard to replicate and impossible to use as a template for a widespread strategy in the fight against HIV/AIDS.

But nine years later, a second man was reported to be HIV-free despite not going back on his medication regimen following similar treatment. At the time, it was too early for that second patient - dubbed "The London patient" - to be officially pronounced as having been cured.

Now, however, a year after those initial reports of a second possible cure, his freedom from the disease has been verified - and the "London patient" has been identified as a man named Adam Castillejo.

The New York Times posted an article about Castillejo, disclosing that although he is now healthy following the bone marrow transplant - which he needed as a treatment for lymphoma -Castillejo's

...journey to the cure has been arduous and agonizing, involving nearly a decade of grueling treatments and moments of pure despair."

Added the Times article:

He wrestled with whether and when to go public, given the attention and scrutiny that might follow. Ultimately, he said, he realized that his story carried a powerful message of optimism.

Castillejo told the Times that he found himself in a "humbling" position as the world's second known person to be cured of HIV, and added, "I want to be an ambassador of hope."

A bone marrow transplant of the sort that Castillejo - and, before him, Timothy Ray Brown - received is a harrowing medical procedure, but even if it could be used on a widespread basis, there was an additional, and crucial, element common to both cases: The donors involved were genetically resistant to HIV.

That, together with the need for transplant recipients to be otherwise compatible with the donors, narrows the field drastically - probably to zero - for almost any given person living with HIV. And, as if those already next-to-impossible odds weren't enough, it seems that even such a rarefied transplant is not a surefire strategy to rid the body of HIV reservoirs; as the Times reported, "there have been many failed attempts" between Brown's apparent cure and Castillejo's. Indeed, some in the medical field prefer the word remission" to "cure," given the possibility that either or both of the men could one day turn out to have still-active reservoirs in their bodies and seroconvert a second time.

But the news comes like a rare point of light in a three-decade-long, and often fruitless, quest for a cure that can be used on a widespread basis. Recent hopes for a vaccine have come to nothing, and though many people living with HIV can control their viral loads through a drug regimen to the point of being undetectable - making it virtually impossible for them to transmit the virus to others - it's unclear how much longer a vaccine will take to achieve, if ever.

Meantime, however, it's been shown that a daily regimen of anti-HIV medication can also shield HIV-negative people from most strains of the virus.

Just the fact that there are now two known cases of HIV being cured - or, if you prefer, being in what seems to be a long-term remission - is heartening.

"It's really important that it wasn't a one-off, it wasn't a fluke," the Treatment Action Group's Richard Jefferys told the Times. "That's been an important step for the field."

Meantime, Castillejo remains pragmatic about his status.

"I don't want people to think, 'Oh, you've been chosen,'" he told the Times. "No, it just happened. I was in the right place, probably at the right time, when it happened."

Kilian Melloy serves as EDGE Media Network's Assistant Arts Editor. He also reviews theater for WBUR. His professional memberships include the National Lesbian & Gay Journalists Association, the Boston Online Film Critics Association, The Gay and Lesbian Entertainment Critics Association, and the Boston Theater Critics Association's Elliot Norton Awards Committee.

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