Transplant May Have Cured Second Patient With HIV

Twelve years ago, scientists performed a stem cell transplant to put a patient with HIV into long-term remission; now, researchers from the University of Cambridge are reporting that a second patient is virus-free after receiving a transplant.

As the authors describe in their Nature article, the patient was diagnosed with HIV in 2003 and developed Hodgkin lymphoma. After his disease proved refractory to standard treatments, he was scheduled to undergo a stem cell transplantation. The transplant team, led by Prof. Ravindra Gupta, an infectious disease specialist at University College London, selected a donor who had two copies of a mutation in the CCR5 gene, which prevents HIV from infecting a patient’s T cells.

The procedure was successful and, 16 months after the transplant, the researchers have found no signs of the virus in the patient’s system. He also volunteered to stop taking antiviral drugs. In total, more than 18 months have passed since the transplant and the virus has not reappeared.

However, the authors cautioned that “it is premature to conclude that this patient has been cured.” Longer follow-up is needed to determine if the HIV has been eradicated.

The results raise hopes that the virus can be eliminated, though this approach will only be available to a small group of patients: Both patients who entered HIV remission had a hematologic malignancy that required a stem cell transplant and had a compatible donor with the CCR5 mutation.

Also, the researchers noted, the transplant was intended to cure the malignancy, not the HIV virus, which can be managed effectively in the long-term with antiretroviral medications.

Source: The New York Times, March 5, 2019; Nature, March 5, 2019.