2023-07-20 06:12:02
In all these cases, the transplant came from a donor carrying the rare CCR5 delta 32 genetic mutation, known to make cells naturally resistant to HIV. The particularity of the patient followed at the HUG, in collaboration with the Institut Pasteur and the Institut Cochin in France as well as the consortium IciStem in the Netherlands, lies in the fact that the transplant comes from a donor who does not carry the mutation.
So, unlike the cells of other people who are considered cured, the cells of this person are not resistant to HIV. Yet, despite this, the virus remains undetectable 20 months following the interruption of antiretroviral treatment. These results will be presented on July 24 at the 26th Congress of the International AIDS Society in Brisbane.
Replaced blood cells
The patient has been living with HIV since the early 1990s and has always been on antiretroviral therapy. In 2018, to treat a particularly aggressive form of leukemia, he underwent a stem cell transplant. One month following the transplant, tests showed that the patient’s blood cells had been completely replaced by donor cells. These results were accompanied by a drastic decrease in HIV-carrying cells.
The antiretroviral treatment was gradually reduced and definitively stopped in November 2021. The analyzes carried out since the treatment was stopped have detected neither viral particles, nor an activatable viral reservoir, nor an increase in immune responses once morest the virus in the patient’s body.
These elements do not exclude that the virus still persists in the body, but they allow the scientific team to consider this patient as a case of remission of the HIV infection. “What is happening to me is magnificent, magical, we are looking to the future”, specifies the patient, quoted in the press release. “We are exploring new avenues with this unique situation in the hope that remission, or even the cure of HIV, is no longer an exceptional event,” explains Alexandra Calmy, head of the HIV/AIDS unit at HUG.
“Although this protocol cannot be transposed on a large scale because of its aggressiveness, this new case provides unexpected information on the mechanisms of elimination and control of viral reservoirs, which will be important for the development of curative treatments for HIV”, concludes Asier Sáez-Cirión, head of the Viral Reservoirs and Immune Control Unit at the Institut Pasteur.
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