German man likely cured of HIV after stem cell transplant, researchers say
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A German man's HIV has likely been cured after undergoing a stem cell transplant in a first-of-its-kind case, scientists announced on Thursday ahead of next week's International AIDS Conference in Munich, Germany.
Why it matters: The 60-year-old has become only the seventh person to be considered cured of HIV — which affects an estimated 39 million people worldwide, including some 1.2 million people in the U.S.
- What scientists found "extremely surprising" in this case was the man appeared to be cured "even though the stem cell donor was not immune to the HIV virus," said HIV expert Christian Gaebler, of the Charité-Universitätsmedizin Berlin, in a statement Thursday.
Driving the news: The patient tested positive for HIV in 2009 and was diagnosed with acute myeloid leukemia (AML) in 2015 — prompting a team at Charité-Universitätsmedizin Berlin to give him the stem cell transplant, per a statement from Europe's largest university hospital.
- Since the patient decided to stop antiviral therapy in 2018, his system has remained functional and no cancer cells have been detected.
- "The virus-free observation period of more than five years now indicates that the HIV virus has actually been completely removed from the patient's body," said professor Olaf Penack, senior physician at the treating clinic, in a statement. "We therefore consider him to be cured of his HIV infection."
Yes, but: Gaebler said that due to the "considerable risks" associated with stem cell transplantation, this procedure is not suitable for use in all HIV infections.
Between the lines: This is the "first case of remission in which the stem cell donor had a single, rather than double, CCR5-delta32 mutation," notes industry magazine Managed Healthcare Executive.
- "In previous cases of remission following stem cell transplants, the stem cell donors had two copies of the CCR5-delta32 mutation, which hampers HIV's ability to infect cells."
- International AIDS Society president Sharon Lewin said at a briefing that the research "suggests that we can broaden the donor pool for these kinds of cases," per NBC News.
- The findings indicate "that you don't actually have to get rid of every single piece of CCR5 for gene therapy to work," said Lewin, who's director of the Peter Doherty Institute for Infection and Immunity in Melbourne, Australia, according to AFP.
The intrigue: Scientists don't yet know why the stem cell transplant led to an apparent cure in this instance, when the virus had multiplied again in other cases.
- "The speed with which the new immune system replaces the old one may have an influence," according to Gaebler.
- "In the second Berlin patient, this was completed relatively quickly, in less than 30 days," added Gaebler, in reference to the hospital treating the first person cured of HIV.
- "But perhaps the donor's immune system also has special properties, such as particularly active natural killer cells, which ensure that even low levels of HIV activity are recognized and eliminated."
The bottom line, via Gaebler: "As soon as we have a better understanding of which factors contributed to the removal of all HIV hiding places in the second Berlin patient, the findings can hopefully be used to develop new treatment concepts such as cell-based immunotherapies or therapeutic vaccines."
- Scientists' goal is to cure HIV infections across the board and not just individual cases, per Gaebler.
Go deeper: Fauci: Ending AIDS epidemic by 2030 may be achievable
