Remission from HIV, which is generally thought to be permanent, comes after a team at Düsseldorf University Hospital destroyed the patient’s cancer cells and replaced them with donor cells that lack CCR5, the receptor that particles of HIV use to infect cells. In 2018, the patient stopped antiretroviral therapy (ART), a treatment that keeps HIV at manageable levels, and has remained HIV-free ever since, according to the newspaper.
He is one of a small handful of people to receive such treatment effectively, including Timothy Ray Brown, who underwent a bone marrow transplant – also to treat leukemia – in Berlin in 2007, and Adam Castillejo, who was declared free of HIV in London in 2019.
Although this treatment is unlikely to be used in non-cancer patients due to its high risks, the research offers further confirmation that HIV is not entirely incurable, as once thought. It also offers hope for a future without daily medical treatment for people living with HIV and highlights the potential for further research aimed at finding a cure.
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Björn-Erik Jensen, the virologist who led the study at the University of Düsseldorf, said in a statement to Nature Medicine that the research “shows that it’s not impossible – it’s just very difficult – to ‘remove HIV from the body’.
Sharon Lewin, director of the Doherty Institute in Melbourne and president of the International AIDS Society, has known the Düsseldorf patient for several years. She said over the phone that the research was “very reassuring”, noting that there are now five patients who have been cured this way.
“It’s real, and it’s repeatable,” she said.
Lewin acknowledged that the approach is “not a reasonable strategy for 38 million people living with HIV” around the world, but said it offered other avenues for more “scalable” research.
“The most important thing is that what we learned from these studies is that if you make every cell resistant to HIV, the virus has nowhere to go and eventually melts away,” she said.
There might be less invasive ways to create this resistance, like the gene therapy, which could modify an HIV-positive patient’s own cells to make them resistant to HIV. Lewin said there have been “very big advances” in gene therapies over the past five years that could make this “very doable”.
The Düsseldorf patient marks the latest development of a disease that was once a fatal diagnosis. Thanks to advances in medicine, it has become a manageable condition for those with access to medication.
HIV damages immune cells and prevents the body from fighting infection. But ART can slow the multiplication of HIV and help an individual’s immune system to strengthen. If people with HIV take the drug daily, they can lower the viral load so that it is ‘undetectable’ and cannot be transmitted to sexual partners. However, HIV, when left untreated, can progress to AIDS.
From 1990 to 2019, deaths from HIV have decreased by 86%. And the average life expectancy after an HIV diagnosis has gone from one year in the 1980s, at the height of the AIDS epidemic, to almost normal, according to the National Institutes of Health.
The research in the Nature article is “inspiring and motivating,” Lewin said.
When someone has just been diagnosed with HIV, they often ask, “Does this mean I’m on treatment forever?” “said Lewin. “As a doctor, I would say, ‘Yeah, that’s right. But there is a lot of work being done to find a cure.
“I think when people hear about cures, it has a very profound effect.”