6th case of HIV remission after transplant announced – 07/20/2023 – Health

A man known as the Geneva patient has shown signs of long-term HIV remission after receiving a bone marrow transplant.

The news is that the bone marrow he received does not have a mutation, already detected by scientists, that manages to block the virus.

His case was presented this Thursday (20) in Brisbane, before the International AIDS Society Conference that starts next Sunday (23) in Australia.

Before him, five other people were considered probably cured after receiving a bone marrow transplant.

All the previous patients had a very particular situation in common: they suffered from blood cancer and benefited from a stem cell transplant that profoundly renewed their immune system.

However, in all these cases, the donors had a rare mutation of a gene known as CCR5 delta 32, which prevents HIV from entering cells.

With the Geneva patient, the situation is different: in 2018, to treat a particularly aggressive form of leukemia, he underwent a stem cell transplant. However, this time, the transplant came from a donor who did not carry the famous CCR5 mutation.

No trace of the virus

Twenty months after he stopped antiretroviral treatment, the virus remains undetected in his body.

The patient is monitored by the University Hospitals of Geneva, in collaboration with the Pasteur Institute, the Cochin Institute and the international consortium IciStem.

His antiretroviral treatment was slowly tapered and permanently suspended in November 2021.

The scientific teams do not rule out that the virus still persists, but consider that it is a new remission of the HIV infection.

Two previous cases, known as the Boston patients, also received normal stem cells during their transplants. However, in both cases, HIV returned in these patients a few months after they stopped taking antiretrovirals.

Asier Saez-Cirion, a Spanish scientist at the Pasteur Institute in France, who presented the case of the Geneva patient in Brisbane, told AFP that if there are no signs of the virus after 12 months, “the probability that it will be undetectable in the future increases significantly”.

There are a few possible explanations why the Geneva patient remains HIV-free, Saez-Cirion said. “In this specific case, perhaps the transplant eliminated all the infected cells without the famous mutation,” she said. “Or perhaps his immunosuppressive treatment, ordered after the transplant, played a role.”

Sharon Lewin, president of the International AIDS Society, which hosted the HIV scientific conference in Brisbane, said the case was promising.

“But we learned from the patients in Boston that just one virus particle can trigger an HIV rebound,” he warned. “This particular individual will need to be closely monitored over the coming months and years.”

While these cases of long-term remission raise hopes for a cure for HIV one day, the aggressive and risky bone marrow transplant procedure is not an option for millions of people living with the virus around the world.

However, the Geneva patient is hopeful that the remission cases may indicate new avenues of research, such as the potential role of immunosuppressive treatments.

Saez-Cirion said the case also motivated scientists to continue studying innate immune cells, which act on the front line of defense against various pathogens.