A fifth person has been cured of HIV after receiving a stem cell transplant from a donor with resistance to the disease.
The patient, a 53-year-old man in Düsseldorf, Germany, received leukemia treatment involving a blood stem cell transplant that also cured the HIV he had been living with since 2008.
The patient shows no signs of active infection four years after ceasing to take antiretroviral drugs. He is the third case of a person being cured of HIV by a stem cell transplant and the fifth known person overall to have been cured of the disease.
How was the patient’s HIV cured?
When the patient was first diagnosed with the virus in 2008, he was placed on antiretroviral therapy (ART) which suppressed the viral load within his system. The patient was then placed in the University Hospital Düsseldorf’s IciStem program, which examines possible HIV cures requiring stem cell transplants.
About three years later, the patient was diagnosed with acute myeloid leukemia. An initial round of chemotherapy reduced the severity of the patient’s cancer but he relapsed the following year in 2012.
Chemotherapy resumed in 2013. This eliminated the blood stem cells in the man’s bone marrow, including the cancerous ones, but chemotherapy is largely indiscriminate and the patient needed replacement donor blood cells.
The doctors found a donor with a mutation that is capable of disabling the CCR5 receptor that HIV uses to infect immune cells. Consequently, the stem cell transplant made the patient’s immune system HIV-resistant.
By 2017, the medical experts were able to cease giving the patient the immunosuppressing drugs required to prevent the rejection of the donor cells. Then, in November 2018, the patient’s antiretroviral treatment was also halted.
Four years later, the patient shows no signs of active infection and it would appear that his HIV has been cured. “We don’t think there’s a functional virus present,” said Björn Jensen at Düsseldorf University Hospital.
Jensen, who was the patient’s physician, first presented findings on the possible HIV cure in 2019. However, he declined to conclude that his patient was indeed in remission at the time as he felt it was too early to say so with full confidence. Nevertheless, he remained “optimistic”.
There have been two other cases of the virus seemingly being cured by stem cell transplants.
Timothy Ray Brown also received a stem cell transplant to treat his leukemia in 2007 and, like the recent case, his HIV was reportedly cured. Last year, a woman who was also receiving treatment for leukemia appeared to be cured after receiving stem cells from an umbilical cord.
Researchers hope that findings from these cases can be used to pioneer new treatments and cures for the disease, which has killed millions.
At present, the vast majority of the nearly 40 million people living with HIV need to take antiretroviral therapy for the rest of their lives to keep the virus in check. This medicine keeps the virus from replicating itself and spreading in the body.
With treatment, people with HIV can lead long, healthy lives, as advancements in therapies and treatments have made what was once a deadly virus into a manageable condition.