Haematopoietic stem cell transplantation to treat severe blood cancers is the only medical intervention that has cured two people with HIV in the past. Another case has now been identified by an international group of physicians and researchers from Germany, the Netherlands, France, Spain, and the United States where HIV infection has been shown to be cured in the same way. In a study published this week i Nature Medicinein which DZIF scientists from Hamburg and Cologne played a key role, the successful healing process of this third patient was characterized for the first time in virological and immunological detail over a period of ten years.
Infection with the human immunodeficiency virus (HIV) was previously considered incurable. The reason for this is that the virus “sleeps” in the genome of infected cells for long periods of time, making it invisible and inaccessible to both the immune system and antiviral drugs. The “Dusseldorf patient,” a 53-year-old man, is now the third person in the world to be completely cured of the HI virus with a stem cell transplant.
The patient, who was treated at the Düsseldorf University Hospital for his HIV infection, received a stem cell transplant for blood cancer. As in the cases of the first two patients named “Berlin” and “London,” the Düsseldorf patient received stem cells from a healthy donor who has a mutation in the genome for the HIV-1 CCR5 co-receptor. This mutation makes it impossible for most HI viruses to enter human CD4+ T-lymphocytes, their main target cells.
After transplantation, the patient was carefully monitored virologically and immunologically for nearly ten years. Using various sensitive techniques, the researchers analyzed the patient’s blood and tissue samples to closely monitor HIV immune responses and the continued presence or even replication of the virus. Shortly after the transplant and over the entire period of the study years, no replicating virus or antibodies or immune cells reactive against HIV were detected. More than four years ago, the antiviral therapy against HIV was discontinued. Ten years after transplantation and four years after the end of anti-HIV therapy, the international research consortium could cure the Düsseldorf patient.
“This case of curing chronic HIV infection by stem cell transplantation shows that HIV can be cured in principle,” says Professor Julian Schulze zur Wiesch, DZIF scientist at the University Medical Center Hamburg-Eppendorf and one of the study leaders. “In particular, the results of this study are also very important for further research into HIV cure for the majority of people with HIV for whom stem cell transplantation is not an option.”