A German Man Who Received A Stem Cell Transplant For Leukemia Has Become The Seventh Person Essentially Cured Of HIV
After receiving a stem cell transplant for leukemia nearly a decade ago, a German man has become the seventh person to have been essentially cured of HIV. Only six other people have achieved this medical milestone in the more than 40 years since the start of the AIDS epidemic.
The 60-year-old man, who has remained unidentified, had been suffering from acute myeloid leukemia (AML) and underwent a stem cell transplant to replace his unhealthy bone marrow in October 2015.
In September 2018, he stopped taking his antiretroviral drugs, which prevent HIV from reproducing, and since then, he has remained in viral remission with no rebound. Multiple tests have determined that there is no HIV in his body.
Dr. Christian Gaebler, a physician-scientist at the Charité-Universitätsmedizin Berlin, will present the case at the 25th International AIDS Conference in Munich. The case has provided vital information for research on HIV cures.
“The longer we see these HIV remissions without any HIV therapy, the more confidence we can get that we’re probably seeing a case where we have really eradicated all competent HIV,” Gaebler said.
Although the man has been in remission for five years, experts warn against using the word “cure.” HIV is notoriously difficult to cure because some of the cells it infects are long-living immune cells that enter or are already in a dormant state.
The standard antiretroviral treatment for HIV only works on immune cells that are making new viral copies. HIV within resting cells stays undetected. They are known as the viral reservoir. A reservoir cell can start producing HIV at any moment, so if people with the virus stop the antiretroviral treatment, more of the virus will be present in the body within weeks.
Stem cell transplants have the potential to cure HIV because they require chemotherapy to destroy an immune system afflicted with cancer and replace it with a healthy immune system from a donor.
A stem cell transplant is an incredibly risky procedure and can be fatal, so very few people with HIV can access this treatment. It is reserved for those with HIV and a separate disease that needs to be treated, like blood cancer.
Gorodenkoff – stock.adobe.com – illustrative purposes only, not the actual person
In all seven patients who have received a stem cell transplant, they contracted HIV and developed blood cancer later on in their lives.
In five of the seven cases, doctors found donors with two copies of a rare genetic mutation that stops HIV from replicating.
The German man received stem cells from a donor with just one copy of the mutated gene. He had one copy himself.
This may have increased his chances of a cure. Around one percent of people with native northern European ancestry have two copies of the defective gene, while having one copy of the gene occurs in 16 percent of such people, broadening the donor pool.
The six other people who were possibly cured of HIV include Timothy Ray Brown, Adam Castillejo, Marc Franke, Paul Edmonds, a patient in New York, and the “Geneva patient.”
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