A European man has achieved a remarkable state of remission from HIV infection for nearly two years following a stem cell transplant to treat his blood cancer. If his condition continues without signs of viable virus, he could join the select group of five individuals considered either or possibly cured of HIV.
This case is unique among the six individuals who had HIV when they received stem cell transplants to treat blood cancers like leukaemia or lymphoma. Unlike the other five cases, this new instance involves a person whose stem cell donor did not possess a rare genetic abnormality that generates resistance to HIV in the targeted immune cells vulnerable to infection.
The man's case will be presented at the upcoming International AIDS Society Conference on HIV Science in Brisbane, Australia. During this major biennial gathering of scientists, notable presentations will cover post-treatment control of HIV in infant boys, the impact of circumcision on HIV risk in gay men, and the relationship between HIV and mpox (formerly known as monkeypox).
Dr. Sharon Lewin, president of the International AIDS Society and director of the Peter Doherty Institute for Infection and Immunity in Melbourne, Australia, expressed enthusiasm about the new viral remission case, emphasising that such case reports contribute significantly to the pursuit of a cure for HIV.
Dubbed as the "Geneva Patient," the man in remission from HIV hails from the Swiss city where he received his treatment. Diagnosed with the virus in 1990, he began antiretroviral treatment in 2005. In 2018, he was diagnosed with an extramedullary myeloid tumour, a rare blood cancer, and subsequently underwent radiation, chemotherapy, and a stem cell transplant. A research team led by Asier Sáez-Cirión, head of the viral reservoirs and immune control unit at the Institut Pasteur in Paris, has overseen the man's case.
Since the first reported case of HIV cure in 2008, three individuals have definitely been cured, and two others are possibly cured pending more time without a viral rebound.
Before the Geneva Patient's case, a few other people with HIV who developed cancer and received stem cell transplants from donors without the rare genetic mutation conferring natural resistance to HIV did not go beyond ten months without a resurgent virus after stopping antiretroviral treatment, dashing hopes of a cure.
The man in Switzerland has now spent 20 months with no viral rebound, having discontinued antiretrovirals in November 2021. Extensive and highly sensitive tests have been conducted to detect HIV in his body, revealing only trace amounts of defective virus. However, it cannot be ruled out that the man may still retain even a single cell infected with a viable virus that could potentially repopulate his body with HIV at any time.
These cases of long-term remission raise hopes that one day HIV can truly be cured. The brutal and risky bone marrow transplant procedure is not an option for the millions of people living with the virus around the world.
The case also encouraged the researchers to continue studying innate immune cells, which act as the first line of defence against various pathogens and could help control the virus. For his part, the Geneva patient said he was now "looking to the future".