For the second time this year and only the fourth time ever, researchers have announced that a person has been cured of HIV. This individual, who had "full blown AIDS" at one point, received a bone marrow transplant after being diagnosed with cancer. While this treatment is only for severe cases of cancer and cannot be applied to the average HIV patient, it has shown that it's possible to eliminate HIV infections, and cure the disease.
This patient has chosen to remain anonymous, but they stated that they once assumed that their 1988 HIV diagnosis was "a death sentence." The patient added that they never thought this day would come, and they are "beyond grateful." The patient has been dubbed the "City of Hope" patient for the California clinic where he was treated.
Infectious disease specialist Jana Dickter of the City of Hope told AFP this patient is the oldest to achieve remission so far, and this success may be promising for other older HIV patients with cancer.
This patient also participated in early antiretroviral therapy trials, which now help about 38 million HIV patients around the world to live with the virus. The City of Hope patient was diagnosed with leukemia in 2019, and then received a bone marrow transplant. The donor cells for the transplant came from a person who carried a mutation in the CCR5 gene; the mutation is known as CCR5-delta 32. Mutations in that gene give people resistance to HIV.
Normally, HIV binds to CCR5 that is expressed on white blood cells, and infects those cell. But when CCR5 is mutated, HIV can't bind to it, so the white blood cells don't get infected, and the disease is never established.
In a bone marrow transplant, the stem cells in bone marrow that produce blood cells, including white blood cells of our immune system, are completely ablated. Then donor cells are used to replace them. The procedure is far too risky for HIV patients, but people who are dying of leukemia can afford the risk.
For this patient, the transplant was successful, and his new white blood cells carried the CCR5 mutation, so the virus, which was already present at very low levels because of the antiretroviral therapy, could not cause disease again.
After getting a COVID-19 vaccination in March 2021, the patient stopped taking antiretrovirals, and they have stayed remission from both HIV and cancer.
This case was announced at an AIDS research conference, where researchers also reported another success story. The viral load of a 59-year-old woman with HIV has been undetectable for 15 years, even though she has stopped retroviral therapy. This patient, a resident of Spain, probably still carries the virus, but at undetectable levels, and her case is different from the City of Hope patient, who does not carry any virus.
HIV is still an infection people carry for life, but these cases have shown that it is possible, potentially with gene editing, to cure the disease. A method that would be accessible to all HIV patients still remains far in the future, however.
Sources: Medical Express via AFP
