Fifth Person Cured of HIV After Stem Cell Transplant

A fifth known person was probably cured of HIV after a specialized stem cell transplant. According to the man’s doctors, he has been living essentially free of the virus for about a decade. Although the treatment is impractical for the general population living with HIV, the insights gained from these patients may help scientists find a more scalable cure later.

The 53-year-old German resident, known only as the Dusseldorf patient (after the city in Germany), underwent the procedure more than nine years ago. He needed the stem cell transplant to treat a case of acute myeloid leukemia, a cancer that affects white blood cells. But his doctors had the opportunity to rebuild his immune system using compatible donor bone marrow from someone with a rare genetic mutation that provides natural resistance to HIV-1, the most common type of the virus.

Although the man has had some health issues over the years (including a brief recurrence of his cancer a few months after the transplant), his HIV viral load has remained consistently undetectable while he continued to receive antiretroviral therapy. At the same time, some tests suggested his body still contained trace amounts of HIV RNA and DNA, while others suggested no surviving fragment would be able to replicate and restart the infection. Eventually, in 2018, his doctors decided to wean him off HIV treatment entirely and monitor him closely. Thankfully the infection hasn’t returned more than four years later and they feel confident enough to declare him cured of HIV.

“Four years after discontinuing analytical treatment, the lack of viral rebound and lack of immunological correlates of HIV-1 antigen persistence provide strong evidence for HIV-1 cure,” they wrote in their publication. published Monday in natural medicine.

There were four other reports of patients who may have been cured after receiving this type of stem cell transplant including two announced last year. Typically, the physicians involved are cautious to explain that her patient has only achieved long-term remission and that it would take longer to confirm a true cure. But this case now appears to be one of the longest gaps between the procedure and sustained HIV-free status.

Over the years there have been some improvements in the feasibility of these transplants for HIV patients. Last year, doctors reported in a woman who achieved sustained remission after being given cord blood, meaning her donor only had to be partially matched. But these procedures are still a high-risk procedure with many potential complications, which is why they’re typically used as a last-ditch option for other conditions like leukemia. And there has been at least one case recently where this type of transplant occurred failed to completely eradicate a patient’s HIV.

While these limitations mean donor stem cells Transplantation will never become a standard HIV cure, it could open new avenues of research and eventually lead to a truly practical treatment, experts say. Some researchers are already to study whether it’s possible to genetically engineer a recipient’s own immune cells in the lab to become HIV-safe and then transplant them back.

In the meantime, according to their own statements, the doctors of the Düsseldorf patient have treated several other patients with donor stem cells, with similarly positive initial results, although it is too early to declare her cured.