AIDS: a fourth patient cured thanks to a bone marrow transplant

He is now the oldest man cured of HIV. At 66, this patient nicknamed “City of Hope”, in reference to the center where he was treated on City of Hope Hospital, based in Los Angeles, is in remission. He had been living with AIDS for 31 years. “When I was diagnosed with HIV in 1988, like many others, I thought it was a death sentence, explained thehe patient “City of Hope” always preferring to remain anonymous. I never thought I would live to see the day when I was HIV free”.

Leukemia and HIV remission

This feat is due to a bone marrow transplant he received in 2019 to, initially, treat leukemia. But the donor stem cells had a rare mutation: part of the CCR5 gene was missing. A rather positive lack because it makes people resistant to HIV. Thus, in March 2021 the patient stopped taking his antiretroviral treatment. Since then, he has been in remission from his leukemia but also from HIV.

This patient is the fourth in the world in remission from AIDS. The first was in Berlin in 2011, a second in London in 2020. Both had, like the patient “City of Hope”, had bone marrow transplants but the difference was that the stem cells were genetically modified to block the implantation of HIV in their body.

Umbilical cord blood

Finally, this year, a third patient was cured of HIV, in New York. She had had stem cells from umbilical cord blood to treat her leukemia. A treatment deemed innovative and promising by the scientific community because it is much easier to obtain umbilical cord blood than stem cells for bone marrow transplants.

A proof

Because this patient (“City of Hope”) was the oldest of four patients to receive a stem cell transplant, lived the longest with HIV before his transplant, and received the least amount of immunosuppressive therapy, we now have evidence that if the right stem cell donor is found for those patients living with HIV who develop cancers of the blood, we can use newer, less intensive chemotherapy options to try to achieve double remission, says Prof. Jana Dickter, City of Hope associate in the Division of Infectious Diseases. This may open up whole new opportunities for elderly patients living with HIV and blood cancer”.

HIV, an STI

HIV is the cause of AIDS, a disease also called “acquired immunodeficiency syndrome”. It is a pathology that destroys the immune defenses of people who are affected. It is also part of sexually transmitted infections (STI), that is to say, infections that are due to bacteria, viruses and parasites transmitted sexually. According to‘Health Insurancethe frequency of STIs is increasing in France, except for HIV, where the annual number of HIV positive findings has been stable since 2007.

But nothing is certain: according to the UNAIDS 2022 report, published on the occasion of the opening of the International AIDS Conference, in Montreal, Canada, the fight against AIDS is currently hampered by global crises. Prevention and access to treatment have been disrupted by the Covid-19 health crisis, while the war in Ukraine and the economic crisis are leading to a drop in resources.