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'London Patient' steps out of the shadows

A year after the “London Patient” was introduced to the world as only the second person to be cured of HIV, The New York Times reports that he is stepping out of the shadows to reveal his identity: He is Adam Castillejo.

Six feet tall and sturdy, with long, dark hair and an easy smile, the report says Castillejo, 40, exudes good health and cheer. But his journey to the cure has been arduous and agonizing, involving nearly a decade of gruelling treatments and moments of pure despair. He wrestled with whether and when to go public, given the attention and scrutiny that might follow. Ultimately, he is quoted in the report as saying, he realised that his story carried a powerful message of optimism. “This is a unique position to be in, a unique and very humbling position,” he said. “I want to be an ambassador of hope.”

Last March, scientists announced that Castillejo, then identified only as the “London Patient,” had been cured of HIV after receiving a bone-marrow transplant for his lymphoma. The donor carried a mutation that impeded the ability of HIV to enter cells, so the transplant essentially replaced Castillejo’s immune system with one resistant to the virus. The report says the approach, though effective in his case, was intended to cure his cancer and is not a practical option for the widespread curing of HIV because of the risks involved.

The report says the news grabbed the world’s attention, and by confirming that a cure is possible, it galvanized researchers. “It’s really important that it wasn’t a one-off, it wasn’t a fluke,” said Richard Jefferys, a director at Treatment Action Group, an advocacy organisation. “That’s been an important step for the field.”

After talking through his decision with his doctors, friends and mother, the report says Castillejo decided the time was right to tell his story. “I don’t want people to think, ‘Oh, you’ve been chosen,’” he said. “No, it just happened. I was in the right place, probably at the right time, when it happened.”

He has enrolled in several studies to help understand both diseases. So far, his body has shown no evidence of the virus apart from fragments the doctors call “fossils” and what seems to be a long-term biological memory of having once been infected.

The report says others in the HIV community are reassured by this news, but expressed concern for Castillejo’s privacy and mental health. “It can be very important for people to have these kinds of beacons of hope,” Jefferys said. “At the same time, that’s a lot of weight for someone to carry.”

Castillejo’s friends have similar worries. But he is as ready as he will ever be, he said. He sees LP as his “work” identity and is determined to live his private life to its fullest. Having lost his lustrous dark hair several times over, he has now grown it to shoulder length. He has always enjoyed adventures, and with careful preparation he has begun traveling again, describing himself to fellow travellers only as a cancer survivor. He celebrated his 40th birthday with a trip to Machu Picchu, in Peru.

But in conversations about his status as the second person ever to be cured of HIV Castillejo still adamantly refers to himself as LP, not Adam. “When you call me LP, it calms me down,” he said. “LP to my name, that is kind of a big step.”

[link url="https://www.nytimes.com/2020/03/09/health/hiv-aids-london-patient-castillejo.html?action=click&auth=link-dismiss-google1tap&login=email&module=Top%20Stories&pgtype=Homepage"]Full report in The New York Times[/link]

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