66-year-old likely cured of HIV after stem cell transplant


A 66-year-old man may be the sixth person to be cured of HIV, the virus that causes AIDS, following a stem cell transplant, according to research published on Wednesday (July 27). The patient, who requests anonymity, is the oldest individual to have had the treatment and achieved sustained remission of the illness.

The guy, referred to as the "City of Hope patient" after the Los Angeles hospital where he received treatment, was initially identified as having the HIV virus in 1988, according to a statement released by City of Hope. Like many others, the patient claimed, "I feared my 1988 HIV diagnosis was a death sentence."

According to the National Institute of Allergy and Infectious Diseases, the first antiretroviral treatment, or HIV medicine, named azidothymidine (AZT), was licensed by the U.S. Food and Drug Administration just a year before, in March 1987. Combination therapy for HIV didn't become widely used until the middle of the 1990s; these medicines included two to three HIV medications to increase treatment effectiveness and help patients avoid developing drug resistance. The current gold standard of care for the treatment of HIV is such combo medicines.

For more than 31 years, the City of Hope patient received antiretroviral medications to manage his HIV. According to NBC News, the man's ailment had at one time developed into AIDS (acquired immunodeficiency syndrome), which meant that his white blood cell count had dropped to dangerously low levels (opens in new tab). Before switching to a very efficient combination antiretroviral therapy in the 1990s, he tried AZT and a few other early HIV drugs that were administered individually.

Acute myelogenous leukemia, commonly known as acute myeloid leukemia, or AML, a malignancy of the blood and bone marrow, struck the patient many decades later, in 2018. Doctors used blood stem cells from a donor who had an unique genetic mutation to perform a blood stem cell transplant as a cancer and HIV therapy. The homozygous CCR5 delta 32 mutation makes its bearer immune to HIV by changing the route through which the virus typically enters the body's white blood cells.

These altered, HIV-resistant cells gradually acquired control of the man's immune system after the transplant. The patient ceased using antiretroviral drugs in March 2021, carefully monitored by his medical team, and there have been no indications of HIV replication in his body since that time.

According to the researchers, the guy is in long-term remission because there hasn't been any sign of the virus in his system for the past 17 months. If his health doesn't change, they may later formally pronounce him "cured," according to NBC News.

The so-called Berlin patient, the first person to be cured of HIV, had a condition that is very similar to the City of Hope patient's.

The Berlin patient, subsequently identified as Timothy Ray Brown, similarly acquired AML and had bone marrow transplanted from a donor with a genetic mutation that made them immune to HIV. (Blood stem cells can be found in bone marrow.) According to NBC News, two further patients from Düsseldorf and London were also successfully treated using the same method, and most recently, one lady was successfully treated following a stem cell transplant utilizing umbilical cord blood cells, as previously reported by Live Science.

David D. Ho, one of the top AIDS specialists in the world and the head of the Aaron Diamond AIDS Research Center at Columbia University, told The Washington Post that the case of the City of Hope patient "is yet another example that mirrors Timothy Brown from years ago" (opens in new tab). However, Ho noted that the majority of HIV patients cannot receive such medicines because of the hazards associated with transplant surgery and the rarity of the HIV-resistant mutation.

According to NBC News, Dr. Sharon Lewin, an infectious-disease specialist at the Peter Doherty Institute for Infection and Immunity at the University of Melbourne in Australia, said at a news conference that even though a transplant is typically not an option for people with HIV, these cases are still intriguing, inspiring, and shed light on the search for a cure. According to The Washington Post, several research teams are seeking to create genome editing methods that might give patients the HIV-resistant mutation.

At the Montreal 2022 International AIDS Conference, Dr. Jana K. Dickter, an associate clinical professor in the Division of Infectious Diseases at City of Hope, discussed the case of the City of Hope patient.