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A man from Geneva becomes sixth person to be declared ‘cured’ of HIV

A patient from Geneva achieves unique HIV remission without genetic immunity, raising hope for potential cure breakthroughs, though uncertainty remains.

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A 50-year-old man from Geneva, Switzerland, has been reported as cured of human immunodeficiency virus (HIV).

The Swiss man achieved long-term HIV remission after undergoing a risky therapy in 2018. HIV remission refers to having an undetectable viral load of the virus after stopping its treatment.

Prior to this case, there have been five other similar cases declared ‘cured’ of HIV, but the patient from Geneva’s case stands out as the most unique.

What sets this case apart is that the patient from Geneva received stem cells from a donor who does not possess a rare genetic mutation known as CCR5.

This gene is essential in blocking the entry of HIV into a person’s immune system, making the cells naturally resistant to the virus. He attained HIV remission after undergoing a stem cell transplant to treat blood cancer or leukemia.

This makes him the sixth person to be pronounced HIV-free. He has been dubbed “Patient Geneva” by scientists, referencing the city where he received treatment during his HIV journey.

After the treatment, the man from Geneva was declared ‘cured’ of HIV, as the virus was no longer detectable in his body after stopping antiretroviral therapy (ART), which is the medication used to suppress the virus in the bloodstream.

He continued the antiretroviral therapy until November 2021 when his doctors instructed him to stop after undergoing the bone marrow or stem cell transplant. “What happened to me is extraordinary, miraculous,” he said in a statement quoted by Euronews.

Although the patient from Geneva has discontinued antiretroviral treatment, researchers are not entirely certain that the HIV virus will not return. Two cases in Boston, where stem cells lacking the CCR5 gene were used for transplantation, saw the virus resurface several months after stopping the antiretroviral medication.

Asier Saez-Cirion, a scientist at the Pasteur Institute in France who presented the case in Brisbane, stated, “If there are still no signs of the virus after 12 months, the likelihood of it remaining undetectable in the future will significantly increase.”

The mystery of the patient from Geneva’s cure lies in the possibility that the transplant eradicated all infected cells without requiring the famous genetic mutation or the immunosuppressive treatment usually needed after transplantation.

Timothy Ray Brown, also known as “Patient Berlin,” was the first person to be cured of HIV.

Timothy Ray Brown, also known as “Patient Berlin,” was the first person to be cured of HIV.

He was diagnosed with HIV while studying in Berlin in 1995 and later diagnosed with leukemia a decade later.

Doctors at the Free University of Berlin used stem cell transplantation from a donor with a rare genetic mutation that gave him natural immunity to HIV. In 2008, Timothy Ray Brown was declared free from both diseases. However, his leukemia recurred, and in September 2020, the International AIDS Society (IAS) announced that Timothy had passed away from leukemia.

Adam Castillejo, the second person to be declared free of the HIV virus.

Adam Castillejo, a 40-year-old man from London, England, became the second person to be declared free of the HIV virus, 30 months after discontinuing antiretroviral therapy. The success of stem cell therapy was documented in a medical journal, The Lancet.

The third person to be cured of HIV was a female leukemia patient from the US who received a stem cell transplant from umbilical cord blood. She has remained HIV-free for 14 months without antiretroviral treatment.

The fourth person in the world to be free from human immunodeficiency virus is a man in his 66s who has lived with HIV since the 1980s. He underwent a bone marrow transplant to treat leukemia from a donor who was naturally resistant to the virus. The 66-year-old man, who prefers to remain anonymous, has now stopped taking HIV medication.

Paul Edmonds, the fifth patient to be declared cured of HIV.

Paul Edmonds, a 67-year-old man from California, Los Angeles, became the fifth person to achieve full remission or be declared cured of Human Immunodeficiency Virus (HIV).

He was named “Patient City of Hopes” after the hospital where he received treatment. Edmonds was diagnosed with HIV-AIDS in 1988 when he was 33 years old. At that time, he received the first antiretroviral therapy that boosted his immune system despite being infected with HIV-AIDS, rendering the virus undetectable and non-transmissible.

In 2012, pre-exposure prophylaxis (PrEP) therapy was introduced into the global market. Users of this daily pill could reduce the risk of HIV transmission through sexual intercourse by up to 99 percent. The combination of both medications allowed Edmonds to survive even though the virus remained in his body.

In 2018, Edmonds was diagnosed with leukemia. While undergoing chemotherapy, doctors discovered that he had the chance to be cured of both dangerous diseases through a rare stem cell transplant.

After receiving treatment, Edmonds stopped taking all the drugs he had been on for half of his life in 2021. He now lives in long-term remission from both HIV and leukemia.

According to the New York Post report, the recovery of the patient from Geneva from HIV differs from the five other individuals who experienced similar cases. The unnamed patient did not have the genetic mutation that makes them immune to HIV, unlike the five other people who achieved HIV remission through stem cell transplantation.

One of the researchers following the treatment progress of the patient from Geneva, Asier Sáez-Cirión, stated, “The possibility of the return of the virus (HIV) is indeed a concern. The virus may persist in rare infected blood cells or anatomical sites that we have not yet analyzed.”

The patient from Geneva was first diagnosed with HIV in 1990. He began antiretroviral therapy (ART) in 2005. Subsequently, he received a stem cell transplant after being diagnosed with a rare blood cancer, an extramedullary myeloid tumor, in 2018.

After undergoing treatment, the virus in the patient’s body did not return, and their ART was stopped in November 2021.

Currently, the patient from Geneva is under the observation of Sáez-Cirión, who is the Head of the Virus Reservoir and Immune Control Unit at the Pasteur Institute in Paris, France. However, the recovery of the patient from Geneva still remains a mystery, as experts cannot precisely determine why the treatment results were successful.

Despite the patient from Geneva having discontinued antiretroviral treatment until now, researchers are not entirely certain that the HIV virus will not return. This is due to two cases in Boston, where stem cells without the CCR5 gene were used, resulting in the virus reemerging several months after stopping the antiretroviral medication.

Asier Saez-Cirion, a scientist at the Pasteur Institute in France who presented the case in Brisbane, said, “If there are still no signs of the virus after 12 months, the likelihood of it remaining undetectable in the future will significantly increase.”

He concluded that the patient from Geneva remains ‘HIV-free’ because the transplant may have removed all infected cells without requiring the famous genetic mutation or the immunosuppressive treatment that is usually needed after transplantation.

Quoted from the Centers for Disease Control and Prevention (CDC) in the US, HIV is a virus that attacks the immune system. If HIV is left untreated, it can lead to acquired immunodeficiency syndrome (AIDS).

Until now, there is no effective cure for the virus, and once a person is infected with HIV, they will carry it for a lifetime. However, with proper medical care, HIV can be controlled, and individuals with HIV who receive effective HIV treatment can live long, healthy lives while protecting their partners.

According to the World Health Organization (WHO), many people may not experience HIV symptoms in the first few months after infection and may not be aware of being infected. Common early symptoms of HIV are similar to the flu, including fever, headache, rash, and sore throat. During these early months, the virus is highly contagious.

As the disease progresses, symptoms may become more extensive and apparent. These can include swollen lymph nodes, weight loss, fever, diarrhea, and cough. HIV weakens the body’s ability to fight other infections, and without treatment, individuals become more susceptible to severe illnesses such as tuberculosis, cryptococcal meningitis, bacterial infections, and some types of cancer, including lymphoma and Kaposi’s sarcoma.

HIV is diagnosed using rapid tests that provide same-day results and can be done at home. However, laboratory tests are needed to confirm the infection.

The modes of HIV transmission include risky sexual behavior, mother-to-child transmission during pregnancy, childbirth, or breastfeeding (although cases of transmission have significantly decreased due to effective HIV treatment). Sharing needles during drug use is also a common route of transmission, and engaging in oral sex, particularly with ejaculation in the mouth when there are sores, bleeding gums, or genital wounds, has been associated with an increased risk of HIV transmission.

To prevent HIV/AIDS transmission, the Centers for Disease Control and Prevention (CDC) recommends four key measures: engaging in safe sexual practices by avoiding multiple partners and using condoms, avoiding illicit drugs, discussing HIV/AIDS diagnosis and prevention with healthcare providers, and being open and honest with partners about HIV status to encourage them to get tested early and take appropriate actions to manage the condition and prevent transmission.

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Malaysia reports new mpox case in man without recent international travel

Malaysia has confirmed its first mpox case of 2024 in a male patient, the Health Ministry reported. The patient is in isolation and stable, with authorities monitoring his contacts. This brings the total confirmed cases since July 2023 to ten, all from clade II.

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MALAYSIA: The Malaysian Health Ministry confirmed a new case of monkeypox (mpox) in a male citizen, marking the country’s first confirmed case of 2024.

The patient, who began showing symptoms on 11 September, is currently in isolation and in stable condition.

The ministry, in a statement issued Tuesday (17 September), revealed that the patient first experienced fever, sore throat, and cough, followed by the appearance of rashes on 12 September.

He has no recent history of international travel within the past 21 days, and authorities are in the process of identifying and monitoring his close contacts, following strict standard operating procedures (SOPs).

“Out of the 58 suspected mpox cases referred to the ministry this year, one case has been confirmed positive for mpox clade II as of 16 September,” the ministry stated.

“All 10 cases reported in Malaysia since July 2023 have been from clade II.”

The Health Ministry had earlier reported that Malaysia recorded a total of nine mpox cases since the first detection on 26 July 2023, with the most recent case reported in November 2023.

All previous cases had links to high-risk activities, but no deaths were reported.

Global Context and National Preparedness

Mpox was declared a Public Health Emergency of International Concern (PHEIC) for the second time on 14 August this year, due to the rapid spread of the clade Ib variant, particularly from the Democratic Republic of Congo (DRC) and neighboring African nations.

In response, Malaysia’s Health Ministry activated its national crisis response centre on 16 August to enhance readiness and coordinate preventive measures.

The ministry advised the public to take precautions, including maintaining personal hygiene and avoiding direct contact with individuals suspected or confirmed to be infected with mpox.

High-risk individuals experiencing symptoms such as fever, swollen lymph nodes, and rashes are urged to seek immediate medical attention.

Mpox is caused by the monkeypox virus (MPVX) and spreads through close contact with symptomatic individuals.

The incubation period is typically between 5 and 21 days, and patients remain contagious until all lesions have dried up and fallen off.

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Singapore to offer Mpox vaccine to high-risk healthcare workers and close contacts

Singapore will offer free mpox vaccines to high-risk healthcare workers and close contacts of confirmed cases, amid concerns over the deadlier clade 1 strain. The Ministry of Health stated mask-wearing is unnecessary for the public, as the virus primarily spreads through close contact.

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Singapore has announced new measures to combat the spread of the deadlier mpox clade 1 strain, as concerns mount over its potential impact.

At a press conference on Wednesday, Health Minister Ong Ye Kung revealed that the mpox vaccine JYNNEOS will be offered to two key groups: healthcare workers at high risk of exposure and close contacts of confirmed cases.

The announcement comes as the World Health Organization (WHO) declared mpox a global public health emergency for the second time in two years due to the resurgence of clade 1 cases in Africa.

Minister Ong emphasized that while there is limited data on the virus, the government has sufficient information to implement precautionary measures. “We do not have full information on the characteristics of this virus, but we have good information on how it behaves,” he said. Ong added that Singapore’s response plan would remain flexible and adapt as the global understanding of the virus evolves.

Response Measures and Border Controls

As part of a whole-of-government approach, the Ministry of Health (MOH) has coordinated a comprehensive public health strategy to prevent the spread of mpox clade 1 in Singapore.

While no direct flights connect Singapore to countries experiencing mpox outbreaks, temperature and visual screening measures have been put in place at Changi and Seletar airports for travellers and crew arriving from affected regions. Screening at sea checkpoints has also been implemented for ships from mpox-affected areas.

Travellers are required to report any mpox-related symptoms (such as fever or rash) and provide travel history via the SG Arrival Card. Those displaying symptoms will be assessed by medical professionals at the borders and referred to hospitals if necessary.

Vaccination Strategy and Quarantine

The JYNNEOS vaccine, previously approved in Singapore for both smallpox and mpox, will be offered to two key groups. Healthcare workers at the National Centre for Infectious Diseases (NCID) and other high-risk facilities will be provided with pre-exposure prophylaxis, in addition to existing infection control protocols. Close contacts of confirmed mpox cases will receive a single vaccine dose within 14 days of exposure during their 21-day quarantine period. The MOH has assured that the current vaccine supply is sufficient to meet the needs of these priority groups.

MOH highlighted that a “significant” portion of the population—those born before 1981—may already have some immunity due to mandatory smallpox vaccinations administered in Singapore until that year.

Detection, Isolation, and Treatment

MOH has instructed all healthcare providers to be vigilant and promptly report any suspected mpox cases, especially those involving clade 1.

Suspected cases will be referred to designated hospitals for further assessment and testing, with paediatric cases directed to KK Women’s and Children’s Hospital and adult-child family groups to National University Hospital. Confirmed clade 1 cases will be isolated in healthcare facilities until they are no longer infectious to prevent further community spread.

Testing for mpox involves polymerase chain reaction (PCR) testing conducted at the National Public Health Laboratory. While there are no rapid point-of-care test kits available, cases are managed through supportive care. For severe cases, antivirals such as Tecovirimat may be used, aligning with treatment protocols in other countries.

Community Measures and Mask-Wearing

Based on current data, the virus spreads mainly through close physical contact, such as within households. Therefore, mask-wearing for the general public is not recommended unless there is significant evidence of respiratory transmission. MOH has stated that if respiratory spread becomes a concern, measures such as mask-wearing on public transport or in crowded indoor spaces may be considered.

In settings such as preschools and schools, existing infectious disease protocols—such as visual screenings for symptoms and hygiene measures—will continue to be implemented to control any potential spread. Additionally, MOH, in collaboration with the Ministry of Manpower and the National Environment Agency, has begun wastewater testing at migrant worker dormitories and the Onboard Centre to detect any presence of mpox.

Ongoing Surveillance and Preparedness

MOH will continue to work closely with international counterparts to monitor the evolving mpox situation. Border measures, detection protocols, and vaccination strategies will be adjusted as needed to safeguard Singapore’s public health.

As of now, Singapore has not detected any clade 1 cases, with all 14 mpox cases this year involving the less severe clade 2 subtype. However, Minister Ong stressed the importance of vigilance, particularly in protecting vulnerable groups such as children and the immunocompromised, should clade 1 reach Singapore.

“Our best course of action is to suppress the spread, provide proper treatment, and have an effective vaccination strategy in place,” Ong said. Despite the concern surrounding mpox, Ong reassured the public that it is unlikely to cause the level of disruption seen during COVID-19.

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