A Third Patient Cleared of HIV After Stem Cell Treatment

Another person has reportedly been cleared of HIV after stem cell treatment. The "Duesseldof patient" became the third person reported to recover from HIV following stem cell treatment.

Two previous recoveries after high-risk stem cell treatment had been reported in Berlin and London. The Dusseldorf patient has now reached the same outcome, with details published on February 20, 2023 in Nature Medicine .

Stem Cell Treatment Was Given for Blood Cancer

The unnamed 53-year-old patient was diagnosed with HIV in 2008 and, three years later, acute myeloid leukemia, a serious blood cancer. In 2013, he received a bone marrow transplant using stem cells from a female donor with a CCR5 mutation that prevented HIV from entering cells.

Consistent tests 4 years later showed no trace of HIV in his body.

The researchers highlighted the significance of the work, saying, "This third case of HIV-1 cure provides valuable insights that we hope will guide future treatment strategies" .

The Patient's Happiness

In a statement, the patient said, "I am proud of my team of doctors from around the world, who succeeded in curing me of HIV and, of course, leukemia at the same time" .

The previous Valentine's Day also marked the 10th transplant anniversary, celebrated with a large gathering at which the donor was the guest of honor.

Who Can Receive a Stem Cell Transplant for HIV?

A cure for AIDS, caused by HIV infection, has long been sought. Bone marrow transplantation is a serious, dangerous procedure, suitable only for a small number of patients with both HIV and cancer. Finding a donor with the rare CCR5 mutation is another major obstacle.

What Is a CCR5 Mutation, and How Does It Protect Against HIV?

The CCR5 gene encodes the CCR5 receptor. The CCR5 receptor occurs on immune-related cells and regulates functions of cells such as T cells, supporting activation against harmful microorganisms and cells. It is also an entry point for HIV. Certain mutations in the CCR5 gene may prevent HIV from binding to the CCR5 receptor. People with CCR5 mutations may have slower HIV progression or avoid infection altogether. CCR5 gene mutations are therefore important in HIV treatment research.

Assier Saez-Cirion of the Pasteur Institute in France, one of the researchers, said, "During transplantation, the patient's immune cells were completely replaced by donor cells, making it possible to eliminate the vast majority of infected cells" .

"This transplant was an exceptional situation in which all the factors aligned for successful treatment of both leukemia and HIV."

Two other patients with HIV and cancer, known as the New York and City of Hope cases, were reported at scientific conferences to have recovered with this method. Their scientific reports have not yet been published.

Recent Developments in CCR5 Gene Therapy for AIDS

Transplanting donor cells with CCR5 mutations through approaches such as stem cell transplantation has recently become an option for some patients with HIV. However, its high cost and risk limit suitability.

Medicines are also being studied in relation to CCR5 gene therapy. They attempt to mimic CCR5 mutations and block viral entry, including maraviroc for resistant HIV. First FDA-approved in 2007, maraviroc is a CCR5 coreceptor antagonist used with other antiretrovirals for HIV-1 in patients aged 2 and older.

Some studies have investigated a biotechnology tool for editing genetic material, CRISPR-Cas9 . Applied to CCR5 in laboratory settings, it has been shown to prevent or slow HIV infection. However, the technique has not yet been tested in clinical practice, and further research is required.

There are also ethical and safety concerns about CRISPR-Cas9. Unwanted or unexpected genetic changes could cause serious health problems, so caution and further research are necessary before using CRISPR-Cas9.

In 2018, Chinese scientist He Jiankui edited CCR5 in two babies in an attempt to increase HIV resistance. Using CRISPR/Cas9, he produced the first births of genome-edited babies; their subsequent situation is unknown. Chinese authorities alleged ethical and legal violations and imprisoned him. He was released in April 2022 after 3 years.

The work provoked opposition from the scientific community and human rights activists worldwide, with many questioning the ethics of such genome editing.

The incident raised questions about the consequences and ethics of CRISPR/Cas9 and prompted calls for stronger legal and ethical rules for human genome editing.

CCR5 gene therapy research continues, and broader clinical trials are needed. Although potentially effective, CCR5 gene therapy does not yet provide a complete solution for HIV.