A high-risk stem cell transplant has cleared a middle-aged man of all signs of the human immunodeficiency virus (HIV) more than nine years after treatment.
The so-called ‘Dusseldorf patient’ was diagnosed with HIV in 2008 and started antiretroviral treatment in 2010. The following year he was diagnosed with leukaemia, which is cancer of the white blood cells in the bone marrow.
Given the serious combination of the man’s illnesses, the doctors decided to go down a dangerous path.
In 2013, the patient underwent a stem cell transplant, which takes stem cells from a donor’s bone marrow or blood and uses the sample to replace a sick patient’s own white blood cells.
In this case, however, the donor was selected because he had a genetic mutation that makes him resistant to HIV. The idea was to cure the patient’s leukemia while giving him genetic resistance to HIV.
Nine years after receiving this initial treatment and four years after he stopped using antiviral treatments, the researchers announced that the patient showed no signs of functional, replicating HIV particles in his body, effectively making him free of virus.
The Düsseldorf patient was the third patient to receive this type of stem cell transplant.
And although there is no clear line between cured and infectious, the Düsseldorf patient joins four other stem cell recipients whom researchers are confident have had all traces of functioning HIV genomes removed from their bodies.
The other patients were dubbed the City of Hope, patients from London, New York and Berlin.
The word “cure” is in quotation marks because it comes with serious caveats.
HIV is one of the most difficult viruses for experts to treat. It has a way of remaining latent in the body, beyond the reach of the immune system or modern drugs.
Stem cell treatments for cancer like the one detailed above are amazing because they can make immune cells resistant to the virus present.
At the same time, however, they are also life-threatening and don’t always work, not even for leukemia. Currently, they are only used as a last resort and in extreme cases.
That said, how some patients are cured with this cutting-edge intervention could “inform future strategies for achieving long-term remission of HIV-1,” write researchers from Düsseldorf University Hospital in Germany.
A handful of additional HIV cases have even been controlled without any stem cell treatment.
These patients were able to stop taking antiretroviral treatments while retaining little or no signs of the virus in their system.
Why this remains unclear, but clinical trials reveal possible avenues for a cure.
In 2022, for example, a common cancer drug was discovered to “coax” latent HIV out into the open.
The drug did not ‘eradicate’ HIV in patients, but its success suggests there are ways to modify the immune system so that it is better able to deal with the long-lasting virus.
Stories like the Düsseldorf patient give scientists hope for the future. It is obviously possible to eradicate HIV, we just have to figure out how to make it work for everyone who needs it.
The study was published in natural medicine.