 Okay, so today I want to talk about the English patient. And no, I'm not talking about the Academy Award-winning film I'm actually talking to who is being dubbed as the London patient, mostly because he chooses to remain anonymous. So the London patient is the second person in history to be cured of HIV, functionally cured of HIV. And I'll get into the details of that in a moment. The first person to ever functionally be cured of HIV is a gentleman by the name of Timothy Brown. And he's also been dubbed the Bertelin patient. So guys, it's important to note that his treatment was actually to treat his leukemia. So he had two bone marrow transfers as well as total body irradiation. So the treatment was actually for the cancer, but he happened to have HIV. And the bone marrow donor happened to have a mutation that made him resistant to HIV. In fact, about 10% of people in Northern Europe have this mutation. And it's a mutation of the CCR5 protein co-receptor. So in short, the London patient is also being treated for cancer and also had a bone marrow transfer while undergoing chemotherapy. So the chemotherapy suppressed his immune system. He was able to have a bone marrow transfer. His body accepted it because of the immune system suppression. And this person had, again, this mutation that was resistant to HIV. And because of that, his body took it in and now he has the HIV resistance. So this is big news. This is a momentous occasion. This is huge. A, because the London patient verifies that what happened with the Berlin patient wasn't just an anomaly. This is something that can be repeated. And it proves that it's actually the treatment that helped this person become HIV resistant. Ravindra Gupta is the leading virologist who is working on this study and regarding the Berlin patient and the London patient. This is what he had to say. By achieving remission in a second patient using a similar approach, we have shown that the Berlin patient was not an anomaly and that it really was the treatment approaches that eliminated HIV in these two people. So that's amazing news. It's a huge step forward. However, it comes with some caveats. So the treatment that was done is very aggressive. Obviously it was given to two cancer patients. Doctors are always weighing risk to benefit. What are the risks and what are the benefits of any given treatment? Antiretroviral therapy has evolved to the point where there's so few side effects, if any, and it also allows HIV patients to live essentially just as long lives as anyone else that it's so manageable that the amount of risk that someone has to undergo to suppress their immune system that badly with something as aggressive as chemotherapy or a radiation treatment in order to get a bone marrow transfer, that's a very invasive, aggressive treatment. So it's just not practical for the general population. And Act Up New York also posted on Twitter responding to the findings that we have. Many advancements for an HIV cure is hopeful, but keep in mind that this was a bone marrow transplantation combined with a rare genetic mutation. Something like this isn't scalable for the millions currently living with HIV and the rollout for it isn't realistic. However, on that note, it is significant because the emphasis is on the CCR5 receptor. Even when I was reading the articles, there's a lot of like terminology and different things that are referenced, medical terms, different parts of cells in the body that I'm just like, I don't really understand what's going on. So I dove in a little bit and tried to understand it a little better. And I'm hoping that hopefully I can help you to understand it a little better as well. So I got put some pictures up. So here is an image of the HIV virus free flowing in the bloodstream next to white blood cells. A lot of people have seen this image. It's been attached to articles that people have sent to me. So you probably have seen the image. So the green is the HIV virus and the yellow is the white blood cell. And I think this is really cool just so that you can visualize what it looks like when it's outside of the cells free flowing in the bloodstream attaching to the blood cell. And yeah, that gives you an idea of that. Now here we have an image of blood cells with the HIV virus inside of it. That's the green part is the HIV virus inside. Now here's another image that someone created of the HIV virus to give you an idea of what it looks like with its little attachments and how it attaches itself to receptors on blood cells. Okay, so here's the really interesting part. So we have the HIV virus up above and then on the bottom and the yellow is the CD4 cell which is a type of white blood cell. So the virus is attempting to attach to the CD4. So what it needs in order to do that is it needs to attach to the CD4 receptor which is shown here in purple. And then it also needs one other co-receptor in order to complete its attachment and excrete its DNA into the CD4 cell. So we've got the CD4 attachment successful. Then it needs the CCR5 co-receptor or the CXCR4 co-receptor in order to fully infuse into the cell. Now, most strains of HIV use the CCR5 co-receptor. That's most strains of HIV, okay? Some, these are rare strains of HIV. They're not very prevalent. Some do use the CXCR4 co-receptor. However, today we're gonna be talking about the CCR5 because this is the most prevalent and this is the one that was useful in allowing the Berlin patient and the London patient to be HIV resistant. So now this is just another picture of that same CD4 cell on the bottom and the HIV virus on top. So as you can see on the left, this person's cell was infected with the HIV virus. Why? Because it had the initial CD4 receptor. It was able to attach. And then the CCR5 co-receptor, it was also attached to that. That initiated the process of HIV infection. However, there is about 10% population in Northern Europe that naturally has a mutated CCR5 co-receptor. These co-receptors will not bind to the HIV virus. So as you can see on the right, the HIV virus is attempting to bind to the CCR5 and it's not happening. Therefore, that CD4 cell, that healthy white blood cell does not get infected, creating an effect in HIV resistance. Great, awesome. So this is exactly what happened. Bone marrow was transferred from this person, this donor who had a mutation in their CCR5 co-receptor. They gave it to the person who was undergoing cancer treatment and then they were able to receive that bone marrow transfer with the stem cells with the mutation in it. And the body incorporated it into its own white blood cells and therefore the patient now has HIV resistance. That's huge. Again, this is something that's not available for the general population. However, now that we are growing into the stages of gene editing, this is big because gene editing allows us to manipulate things like co-receptors. And so we can find other ways of manipulating the CCR5 co-receptor or perhaps even the CXCR4 co-receptor allowing people to become resistant to HIV on a much grander scale. So that's the exciting part, is that we know how to help someone become HIV resistant. We know what we need to work on and to focus on. That's the important part. Not the fact that this person had bone marrow transfer. That's great and that's awesome for these two and it's a huge step, but the big win is really solidifying what it is that allows someone to become HIV resistant and then applying that knowledge to something like gene editing. And gene editing is very much in its infancy. So that's not something that's gonna happen overnight. I couldn't tell you when it will happen, but it gives us a pathway and it gives us hope and it gives us possibilities for the future. And so Gupta goes on to say, "'Continuing our research, we need to understand "'if we could knock out this receptor in people with HIV, "'which may be possible with gene therapy.'" So again, I want to reiterate that this is really good news, but we need to keep it in context and realize what the implications are and what it really means as far as the progress towards an HIV cure. Also, it's important to note that despite the fact that this person has become resistant to HIV, there are still what are called reservoirs of HIV in cells that have already been infected in the person's body. So the person is not completely absent of the HIV virus. Whatever was already able to infect certain cells in the body, that HIV will stay intact right where it is for the duration of the person's life or if for some reason the HIV resistance was no longer applicable. So that's why they're not just saying cure, they're saying functional cure because practically speaking, it's cured. Although in reality, there are potentially reservoirs of the virus still inside both of the patients. It's a really tricky virus, guys. So there are a lot of factors that have to be considered in this battle against HIV. It's why it makes it so tricky and also this virus is highly adaptable also. The London patient who has chosen to remain anonymous has been off of ARV's antiretroviral treatment for 18 months as of now and in that time has remained undetectable. For those of you who aren't familiar when the antiretroviral treatment is doing its job, suppressing the HIV virus, keeping it from being able to replicate, you become what's known as undetectable. There's no detectable trace of HIV in your blood, which is great. That means it's not affecting your body, it's not affecting your health and therefore also you are unable to transmit it to someone else. That's huge. However, it's only been 18 months and science is science. So it's too early to say that he is for sure functionally cured. However, this is a really, really, really good sign and they will be monitoring him for years to come. Guys, I hope this was informative. For those of you who aren't familiar, I hope that this kind of made it easier to understand what's going on and what the implications are for those of us living with HIV and for the hope of an HIV cure in the future. I hope to do a lot more videos like this to help you understand, relate and be able to explain this in a way that is just a little bit more understandable and not so like heady and out there. So please like this video if you liked it. Go ahead and subscribe if you haven't already. I've got a lot of great content on this channel, not just about HIV, but about fitness. I'm a natural competitive bodybuilder and about just becoming a better person and living your best life. So that's what this channel is all about. Stick around, I got a lot more great content coming for you a lot more frequently too. So that's exciting. And let me know in the comments if this helped you. And if I said something wrong, please let me know. Call me out. I love to be called out and to be told that I'm wrong so that I can therefore adjust my brain and figured out correctly. And if I did say something wrong or I am spreading misinformation, I apologize ahead of time, but it did my best to learn this really quickly and then be able to reinterpret it in a way for you guys to be able to understand it easier to do if that made any sense. Okay, guys, this is awesome. Chin up, have hope, and I will see you soon. Peace.