Man in Long-Term Remission from HIV Without Virus-Blocking Gene Mutation, Researchers Say
The “Geneva patient” has become the latest individual to be declared in long-term remission from HIV, making him the sixth person to achieve this milestone. However, unlike previous cases, the patient did not receive a bone marrow transplant with a virus-blocking gene mutation, according to researchers.
The previous five individuals considered “cured” of HIV, known as the Berlin, London, Duesseldorf, New York, and City of Hope patients, all underwent bone marrow transplants to treat severe cases of cancer. These patients received stem cells from donors who carried a mutation of the CCR5 gene, which blocks the entry of HIV into the body’s cells.
In 2018, the Geneva patient received a stem cell transplant to combat an aggressive form of leukemia, similar to the previous cases. However, this time, the transplant came from a donor who did not possess the CCR5 mutation. French and Swiss researchers shared this information during a press conference in Brisbane, Australia, as part of an upcoming AIDS conference.
Due to the absence of the CCR5 mutation, the virus is still capable of entering the patient’s cells. However, even after stopping antiretroviral treatment for 20 months – medication that reduces the amount of HIV in the blood – doctors at Geneva University Hospitals found no trace of the virus in the patient’s system.
The researchers stated that they cannot definitively rule out the return of the patient’s HIV but consider him to be in long-term remission. The Geneva patient, a white man who chose to remain anonymous, expressed his gratitude, calling the developments “magnificent” and “magical.”
Two previous cases, referred to as the Boston patients, also received normal or “wild type” stem cells during their transplants. However, HIV resurfaced a few months after they discontinued antiretroviral therapy.
Asier Saez-Cirion, a scientist at France’s Pasteur Institute, who presented the Geneva patient’s case, explained that if no signs of the virus are detected after 12 months, the probability of its future undetectability significantly increases. Saez-Cirion proposed two potential explanations for the patient’s HIV-free status: either the transplant eliminated all infected cells without the need for the CCR5 mutation, or the immunosuppressive treatment administered post-transplant played a role.
Sharon Lewin, president of the International AIDS Society, referred to the case as “promising” while cautioning that even a single viral particle can trigger HIV rebounding, as demonstrated by the Boston patients. She emphasized the need for close monitoring of the Geneva patient in the coming months and years.
While these cases of long-term remission provide hope for an eventual cure for HIV, the bone marrow transplant procedure remains a risky and drastic option that is not practical for the millions of individuals living with the virus worldwide. Rather than a cure, it serves as a last-resort treatment for life-threatening cancer in HIV-positive patients.
Nevertheless, researchers believe that these remission cases could open up new avenues of research, such as exploring the role of immunosuppressive treatments. The Geneva case has inspired further study into innate immune cells, which act as the body’s initial defense against various pathogens and may assist in controlling the virus.
Looking to the future, the Geneva patient remains optimistic. These encouraging developments renew hopes for advancements in HIV research and potential breakthroughs in managing the virus.
© Agence France-Presse