Transplant said to cure HIV patient

A man in Germany who had been diagnosed with HIV has been declared free of the virus after receiving HIV-resistant stem cells through a bone marrow transplant intended to treat leukemia. According to research published in the journal Nature Medicine, the man was monitored for more than nine years after the 2013 transplant, and there is now “strong evidence” that he has been cured.

The remission of HIV, which is usually considered lifelong, comes after a team at University Hospital Dusseldorf destroyed the patient’s cancerous cells and replaced them with donor cells that lack CCR5, the receptor that HIV particles use to infect cells. In 2018, the patient went off antiretroviral therapy, a treatment that keeps HIV at manageable levels, and has remained free of HIV since, the paper said.

He is one of a small handful of people to receive such treatment effectively, including Timothy Ray Brown, who had a bone marrow transplant, also to treat leukemia, in Berlin in 2007, and Adam Castillejo, who was declared free of HIV in London in 2019.

While this treatment is unlikely to be used with non-cancer patients because of its high risks, the research offers further confirmation that HIV is not entirely incurable. It also offers hope for a future without daily medical treatment for those with HIV and underscores the potential for other research pursuing a cure.

Bjorn-Erik Jensen, the virologist who led the study at Dusseldorf University, said in a statement to Nature Medicine that the research “shows it’s not impossible, it’s just very difficult, to remove HIV from the body.”

Sharon Lewin, director of the Doherty Institute in Melbourne and president of the International AIDS Society, has known about the Dusseldorf patient for several years. She said by phone that the research was “very reassuring,” noting that there have now been five patients who have been cured through this pathway.

Lewin acknowledged that the approach is “not a reasonable strategy for 38 million people living with HIV” globally but said it offers other avenues for more “scalable” research.

“The most important thing is that what we’ve learned from these studies is that if you make every cell resistant to HIV, the virus has got nowhere to go and eventually melts away,” she said.

There could be less invasive ways to create that resistance, such as gene therapy, which could make it possible to modify an HIV patient’s own cells to make them HIV-resistant. Lewin said there have been “some really big advances” in gene therapies over the past five years that might make this “highly feasible.”