Dusseldorf University Hospital – credit duesseldorf-health.de
The “Düsseldorf Patient”, a man now aged 53, is just the third person worldwide to have been completely cured of HIV via stem cell transplantation.
As in the case of the other two patients, the so-called “Berlin Patient” and “London Patient,” the transplantation was undertaken to treat an acute blood disease, which had developed in addition to the HIV infection.
The Düsseldorf Patient received a stem cell transplant used to treat leukemia in 2013 and has shown persistent suppression of HIV-1 ever since, including during the last 4 years after the patient stopped taking anti-retroviral medication.
“I still remember very well the sentence from my family doctor: ‘don’t take it so hard,’” the Düsseldorf Patient, who had leukemia as well as HIV-1, said in a statement. “‘We will experience together that HIV can be cured!’ At the time, I dismissed the statement.”
Allogeneic hematopoietic stem cell transplantation (HSCT) is a procedure used to treat certain cancers, such as leukemia, by transferring immature blood cells from a donor to repopulate the bone marrow of the recipient.
Scientists now understand that individuals with two copies of the Δ32 mutation in the gene for the HIV-1 co-receptor CCR5; are resistant to HIV-1 infection. The two previous cases of both the London patient and the Berlin patient involved receiving a stem cell transplant from a donor with these unique mutations.
Björn-Erik Jensen, a specialist in infectious diseases at Düsseldorf University Hospital, lead the treatment and subsequent research, revealed today in a peer-reviewed study in Nature.
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The patient was diagnosed as having acute myeloid leukemia and proceeded to undergo transplantation of stem cells from a female donor in 2013, followed by chemotherapy and infusions of donor lymphocytes.
After the transplantation, anti-retroviral therapy was continued, but HIV was undetectable in the patient’s blood cells. Anti-retroviral therapy was suspended in November 2018 with the patient’s informed consent, almost 6 years after the stem cell transplantation, to determine whether the virus persisted in the patient.
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“I very much hope that these doctors will now get even more attention for their work,” said the patient. “I have now decided to give up some of my private life to support research fundraising. And of course, it will also stay very important for me to fight the stigmatization of HIV with my story.”
The authors conclude that although HSCT remains a high-risk procedure that is at present an option only for some people living with both HIV-1 and hematological cancers, these results may inform future strategies for achieving long-term remission of HIV-1.
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