A fourth person is effectively ‘cured’ of HIV, and is the oldest patient to date

AIDS researchers announced on Wednesday that a fourth person had been ‘cured’ of HIV, but the dangerous procedure for patients who are also battling cancer may not bring comfort to the tens of millions of people living with the virus in the world. world.

The 66-year-old, dubbed the “City of Hope” patient after the California center where he was treated, was declared in remission ahead of the International AIDS Conference, which begins Friday in Montreal, in Canada.

He is the second person to be announced cured this year, after researchers said in February that an American woman dubbed the New York patient had also gone into remission.

The City of Hope patient, like patients in Berlin and London before him, achieved lasting remission from the virus after a bone marrow transplant to treat cancer.

Another man, the Düsseldorf patient, is also said to have reached remission, potentially bringing the number of recoveries to five.

Jana Dickter, an infectious disease specialist at the City of Hope, told AFP that as the latest patient was the oldest to not yet achieve remission, its success could hold promise for older people with the disease. HIV who also have cancer.

Dickter is lead author on the patient research that was announced at a pre-conference in Montreal but has not been peer-reviewed.

“I am beyond grateful”

“When I was diagnosed with HIV in 1988, like many others, I thought it was a death sentence,” said the patient, who does not wish to be identified.

“I never thought I would live to see the day when I was HIV free,” he said in a City of Hope statement. “I am beyond grateful.”

Dickter said the patient told him about the stigma he faced at the start of the AIDS epidemic in the 1980s.

“He saw many of his friends and loved ones become very ill and eventually succumb to the disease,” she said.

He had “full AIDS” for a time, she said, but was among the first trials of antiretroviral therapy, which now helps many of the 38 million people living with HIV worldwide. to live with the virus.

He had HIV for 31 years, longer than any previous patient who went into remission.

After being diagnosed with leukemia, in 2019 he received a bone marrow transplant with stem cells from an unrelated donor with a rare mutation in which part of the CCR5 gene is missing, making people resistant to HIV. .

He waited until he was vaccinated against COVID-19 in March 2021 to stop taking antiretrovirals and has since been in remission from HIV and cancer.

The reduced-intensity chemotherapy worked for the patient, potentially allowing older HIV-positive cancer patients to get the treatment, Dickter said.

But it is a complex procedure with serious side effects and “is not an appropriate option for most people living with HIV”, she added.

Steven Deeks, an HIV expert at the University of California, San Francisco who was not involved in the research, said “the first thing you do during a bone marrow transplant is to temporarily destroy your own immune system”.

“You would never do this if you didn’t have cancer,” he told AFP.

‘Holy Grail’

At the AIDS conference, research was also announced on a 59-year-old HIV-positive Spanish woman who maintained an undetectable viral load for 15 years despite stopping antiretroviral therapy.

Sharon Lewin, president-elect of the International AIDS Society which is convening the conference, said it was not quite the same as the City of Hope patient because the virus remained at a very low level.

“A cure remains the holy grail of HIV research,” Lewin said.

“We have already seen a handful of individual recovery cases and the two presented today are a source of hope for people living with HIV and inspiration for the scientific community.”

She also pointed to a “really exciting development” towards identifying HIV in an individual cell, which is “a bit like finding a needle in a haystack”.

Deeks, author of the new research also presented at the conference, said it was an “unprecedented deep dive into the biology of the infected cell”.

Researchers have identified that a cell infected with HIV has several unique characteristics.

It can proliferate better than most, is hard to kill, and is both hardy and hard to detect, Deeks said.

“That’s why HIV is a lifelong infection.”

But he said cases such as the City of Hope patient offered a potential roadmap to more widely available treatment, possibly using CRISPR gene-editing technology.

“I think if you can get rid of HIV and CCR5, the doorway that HIV comes in, then you can cure somebody,” Deeks said.

“It’s theoretically possible – we’re not there yet – to give someone an injection in the arm that will deliver an enzyme that will go into the cells and knock out CCR5, and knock out the virus.

“But that’s science fiction for now.”

© Agence France-Presse

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