A 66-year-old man has become the fourth patient to be effectively cured of a HIV infection after undergoing a stem cell transplant from a donor with a rare genetic mutation that has been linked to HIV resistance. The man, now in remission for 17 months, is the oldest to have successfully undergone this still experimental procedure.
Fifteen years ago a man named Timothy Brown was diagnosed with acute myeloid leukemia. A hematopoietic stem cell transplant was the only treatment option available to him. Brown also happened to be HIV positive. So as an experiment, his doctor sought out a stem cell donor who also carried a rare genetic mutation known to confer resistance to the HIV virus.
Incredibly, within three months of the first stem cell transplant, Brown went into HIV remission. He ceased antiretroviral therapy and was functionally cured. He became known as the Berlin Patient, and since that case there have been two more reported instances of this kind of stem cell therapy effectively curing patients of HIV.
The newly reported case concerns a 66-year-old man who was first diagnosed with HIV back in 1988. He developed leukemia a few years ago and was given hematopoietic stem cell therapy in 2019, using a donor with the crucial rare genetic mutation.
Due to the COVID-19 pandemic, researchers were hesitant to wean him off his antiretroviral therapy until he was vaccinated in 2021. He has now been monitored for the 17 months he's been off his antiviral drugs, and continues to remain in remission from HIV.
“Because this patient was the oldest to receive a stem cell transplant [of the four patients cured of HIV in this way], has lived the longest with HIV prior to his transplant, and received the least immunosuppressive therapy, we now have evidence that if the right stem cell donor is found for patients living with HIV who develop blood cancers, we can use newer and less intensive chemotherapy regimen options to try to achieve a dual remission,” explained Jana Dickter, a clinician working with the patient. “This may open up whole new opportunities for older patients living with HIV and blood cancer.”
The success with this older patient is a promising step forward for the treatment. Because this kind of stem cell treatment is toxic and very physically challenging it isn’t appropriate as a therapy for subjects solely suffering from HIV infection. Instead it can only really be administered to HIV patients who subsequently develop very serious forms of blood cancer. And in this instance, treating an older patient successfully with a more tolerable, modified form of the stem cell treatment bodes well for future uses in older subjects.
Dickter said it’s a landmark to see this therapy work effectively in a patient who had lived with HIV for more than 30 years.
“We were thrilled to let him know that his HIV is in remission and he no longer needs to take antiretroviral therapy that he had been on for over 30 years,” added Dickter. “He saw many of his friends die from AIDS in the early days of the disease and faced so much stigma when he was diagnosed with HIV in 1988. But now, he can celebrate this medical milestone. We can find no evidence of replicating HIV in his system.”
Source: City Of Hope
