Scientists highlighted that the cure for HIV is “exceptionally rare”, as only six cases have been documented among the nearly 88 million people who have contracted the virus.
MADRID, 2 Dic. (EUROPA PRESS).- Researchers germans They managed to eliminate the HIV of a 60-year-old patient undergoing a stem cell transplant to treat the leukemia who suffers, according to a study published in the magazine Nature.
As its authors recognize, the treatment of the HIV It is exceptionally rare, documented in only six cases among the approximately 88 million individuals who have acquired the disease. virus since the beginning of the Epidemic.
In this sense, they point out that successful cures, including the so-called “Berlin patient”, are limited to individuals who receive allogeneic stem cell transplants (allo-SCT) for hematological cancers.
They explain that HIV resistance from stem cell donors with the rare homozygous CCR5delta32 mutation was long considered the primary mechanism for HIV remission without antiretroviral therapy (ART), but recent reports highlight CCR5-independent mechanisms as important contributors to HIV cure.
Now, the new case provides further evidence for this conceptual shift, achieving an “exceptionally long” and treatment-free HIV remission after allo-SCT with functionally active CCR5. Specifically, the patient has been free of the virus for six years after the stem cell transplant.
This patient, a CCR5 wild-type/delta32 heterozygous man living with HIV, received allo-SCT from an HLA-matched unrelated CCR5 wild-type/delta32 heterozygous donor as treatment for acute myeloid leukemia.
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Three years after the allogeneic stem cell transplant, the patient discontinued antiretroviral treatment and, the researchers confirm, to date, “HIV remission has been maintained for more than six years with undetectable plasma HIV RNA.”
They explain that analysis of the reservoir revealed intact proviral HIV before transplant, but no virus with the capacity to replicate in blood or intestinal tissues after allogeneic stem cell transplant.
Therefore, they point out that the decrease or absence of HIV-specific antibody and T lymphocyte responses supports the absence of viral activity, and point out that the high activity of antibody-dependent cellular cytotoxicity (ADCC) at the time of transplant could have contributed to the elimination of the HIV reservoir.
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These results demonstrate that CCR5delta32-mediated HIV resistance is not essential for durable remission, underscoring the importance of effective reduction of the viral reservoir in HIV cure strategies, they conclude.