New Delhi: Over the nine years following treatment, a 53-year-old leukemia patient who underwent an allogeneic hematopoietic stem cell transplant displayed signs of suppressed human immunodeficiency virus type 1. According to the study, the patient from Düsseldorf, Germany, is now “alive and in good health.”
Three people have been cured of HIV through a bone marrow transplant to date. Overall, five have either been cured or possibly cured of HIV. So far, two people so far have naturally fought off the infection without any medical intervention or treatment.
The study conducted by senior physician Björn-Erik Ole Jensen and his team was published in Nature Medicine on 20 February. The team says that the allogeneic hematopoietic stem cell transplant is a strong answer to curing HIV-1 and has been observed in two patients earlier. During the treatment, a patient receives healthy blood-forming cells from a donor to replace their own stem cells, which have been eroded by radiation or chemotherapy.
The 53-year-old patient had been diagnosed as HIV-1 positive in January 2008 and with acute myeloid leukemia in 2011. But by September 2012, he had achieved complete remission of the disease from chemotherapy.
After the bone marrow transplant treatment, the patient still showed meagre traces of the virus. However, it stopped replicating itself when the cells from the human were transferred into a mouse to assess the effectiveness of the treatment. He also displayed a lack of antigen production or a low immune response.
The said cancer treatment is one in which blood cells are transferred from a donor to the ailing, to repopulate the affected bone marrow of the recipient. The cells of the donor carry certain mutations that are resistant to HIV-1 and thus contribute to the suppression of the virus.
While there is no established way to fight off HIV as such, the patient had also undergone anti-retroviral therapy (ART), a standard HIV treatment, to control the infection at the time. This therapy involves drugs that help the afflicted live a longer and healthier life.
That therapy had ceased in November 2018, after the patient’s consent. It typically takes 8-10 years for untreated HIV to become AIDS, which hampers one’s immune system and invites a host of other diseases.
The effects of the cancer treatment on HIV-1 have been observed earlier in two patients. Two patients from London and Berlin had received similar cell transplants, which showed resistance to the HIV-1 present in their systems.
The one from Berlin was the first to be cured of HIV (2008) – Timothy Ray Brown, who was from California. However, he passed away in 2020 from leukemia.
Adam Castillejo, from London, was the second person to survive the disease (2019). Both of them underwent an expensive bone marrow transplant from a donor with a rare genetic mutation that is resistant to HIV. He was also on antiretroviral therapy.
The first woman to be cured of AIDS received a novel umbilical cord blood transplant just last year. Thus, this makes the 53-year-old man the third in the world to experience long-term HIV remission from the bone marrow transplant treatment.
While this treatment won’t easily be scalable, the authors say that it is still indeed a relevant strategy to achieve long-term HIV-1 remission. In the long fight against AIDS, another case of viral remission is a reason to have some hope.
With success in three patients now, this approach can be applied to wild-type stem cell grafts using gene therapy, and could indeed go a long way in providing a cure for AIDS and cancer both.
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