April 18, 2024

Sixth HIV Patient Announced in Remission “Needs Close Watch” : ScienceAlert

A man known as the “Geneva patient” is the latest person with HIV to be declared in long-term remission – but he did not receive a transplant with a gene mutation that blocked viruses like in previous cases, researchers said Thursday.

Five people were previously considered “cured” of HIV: patients in Berlin, London, Duesseldorf, New York and City of Hope, California.

They all underwent bone marrow transplants to treat severe cases of cancer, receiving stem cells from a donor with a mutation of the CCR5 gene. This mutation is known to prevent HIV from entering the body’s cells.

In 2018, a Geneva patient similarly received a stem cell transplant to treat a very aggressive form of leukemia.

But this time the transplant came from a donor who did not carry the CCR5 mutation, the French and Swiss researchers said at a press conference in the Australian city of Brisbane as part of AIDS conference which starts at the weekend.

This means that the virus is still able to enter the patient’s cells.

However, 20 months after the man stopped antiretroviral treatment – which reduces the amount of HIV in the blood – doctors at Geneva University Hospitals found no trace of the virus in his system, the researchers said.

Although they can’t rule out that the man’s HIV will come back, the researchers said they believe he is in long-term remission.

“What is happening to me is amazing,” said the patient in Geneva in a statement.

The patient, a white man who chose not to be named, was diagnosed with HIV in 1990.

He was on antiretrovirals until November 2021, when his doctors advised him to stop the treatment after the bone marrow transplant.

Commitment

His previous cases, known as the Boston patients, received normal or “wild-type” stem cells during their transplants. But in both cases, HIV returned a few months after they stopped taking antiretrovirals.

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

There were a few possible explanations for why the Geneva patient remains HIV-free, Saez-Cirion said.

“In this specific case, the transplant may have eliminated all the infected cells without the need for the famous mutation,” he said.

“Or maybe his immunosuppressive treatment, which was needed after the transplant, played a role.”

Sharon Lewin, president of the International AIDS Society which runs the HIV science conference in Brisbane, said the situation was “promising”.

“But we learned from the Boston patients that even one particle” of the virus can lead to HIV rebounding, she warned.

“It will be necessary to keep a close eye on this particular individual in the months and years to come.”

While these cases of long-term remission hold hope that one day HIV may truly be cured, the brutal and dangerous procedure of bone marrow transplant is not an option for the millions of people around the world who have the virus.

Rather it is a last-ditch effort to treat life-threatening cancers in people who also have HIV.

However, it is hoped that the cases of remission could focus on new avenues of research, such as the possible role of immunosuppressive treatments.

Saez-Cirion said the case also encouraged researchers to continue studying innate immune cells, which act as the first line of defense against various pathogens, and may help control the virus.

For his part, the patient in Geneva said he was now “looking to the future”.

© Agence France-Presse

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