“The patient of Düsseldorf” received a stem cell transplant to treat leukemia, then was able to interrupt his antiretroviral treatment against HIV in a supervised manner. Four years later, no more trace of the virus is detectable in his body.
Mo12345lemonde with AFP
This is a new official case of healing of HIV after a bone marrow transplant: the “Düsseldorf patient” no longer has any trace of the virus in his organism, indicate work Published Monday February 20 in Nature Medicine .
Only two similar cases of healing have been described so far in scientific publications: the “Berlin patient” in 2009 and the “London patient” in 2019. Two other healing cases were detailed in the year Last during scientific conferences, but have not yet given rise to publications in good and due form.
This third patient, a man followed in Düsseldorf, received a stem cell transplant to treat leukemia, then was able to interrupt his antiretroviral treatment against HIV, described the international consortium iCistem , whose Pasteur Institute is a partner, in the study.
In their analyzes, the researchers have not found viral particles, neither an activated viral reservoir, nor immune responses against the virus in this person’s body despite stopping treatment for four years.
Patients with blood cancer
Healed patients all have a very special situation in common. They were suffering from blood cancers and benefited from a stem cell transplant which has deeply renewed their immune system.
Their donor presented a rare mutation of a so -called CCR5 gene, a genetic mutation known to prevent the entry of HIV into cells.
“During a bone marrow transplant, the patient’s immune cells are fully replaced by those of the donor, which makes it possible to make the vast majority of infected cells disappear”, explains, in a press release, the Asier virologist Saez-Cirion, one of the authors of the study. “This is an exceptional situation when all these factors coincide for this transplant to be a double success of healing, leukemia and HIV,” said the researcher.
a complex intervention Major risks 2>
Given that less than 1 % of the general population carries this protective mutation of HIV, it is indeed very rare that a compatible marrow donor has this mutation. Div> Every day new crossed, sudoku and words found. Play section>
In 2018, the medical team no longer detected the presence of viruses and planned with the patient a monitoring of antiretroviral treatment against HIV.
But if these cases of remissions bring hope to researchers to end up one day by HIV, a bone marrow transplant remains a very heavy and risky operation: it is not adaptable to most carriers of the virus . The “Düsseldorf patient” however brings hope to the scientific world which has devoted itself to the fight against HIV for forty years.
“Different strategies are being studied. Some seek to specifically target and eliminate infected cells, others to make cells resistant to infection without going through a transplant by introducing for example the CCR5 Delta-32 mutation via gene therapy, and ultimately other strategies aim to optimize immune responses against the virus, “explains the virologist Asier Saez-Cirion.