HIV: A fourth and oldest patient who has not recovered following a cell transplant has entered remission

HIV: A fourth and oldest patient who has not recovered following a cell transplant has entered remis ...

Researchers announced that a 66-year-old man had achieved long-term HIV remission three years after receiving a stem cell transplant for leukemia on Wednesday, July 27, 2022, in advance of the 24th International AIDS Conferencein Montreal.

Because he was treated at City of Hope, a cancer facility in Duarte, California, the man, who has chosen to remain anonymous, is only the fourth person in the world to undergo long-term remission following a stem cell transplant.

He is the oldest patient in the group, and the one who has lived with HIV the longest since he first tested positive in 1988.

In a statement, a City of Hope patient says she thought HIV diagnosis was a death sentence. I never anticipated I would live to see the day that I no longer have HIV.

A lengthy process

According to Dr. John Zaia, director of the City of Hope's Center for Gene Therapy and one of the practitioners who cared for the patient, a stem cell transplant took place more than three years ago.

In a press conference with Medical News Today, Dr. Zaia explained that for a while, you're just waiting, because you're hoping that the transplant will cure that leukemia and that everything is going well.

During that time, the person is on anti-HIV medication, so HIV is under control, and you're wondering if you're capable of recommending to the person to stop taking his medications, he added.

Doctors no longer saw evidence that the patient was carrying a replication of the HIV virus about two years after the transplant, according to Dr. Zaia. At that point, we all agreed that asking him if he wanted to stop his therapy would be ethical. He did.

Is there a scientific breakthrough?

Two infectious disease specialists contacted by MNT fell short of calling the news that a fourth person has returned to HIV after undergoing a stem cell transplant a scientific milestone.

Dr. William Schaffner, professor of medicine in the division of infectious diseases at the Vanderbilt University School of Medicine in Nashville, Tennessee, told MNT.

Experts believe stem cell transplants are too risky to be considered for HIV patients unless the individual needs to be treated for a potentially fatal cancer.

Dr. Schaffner described stem cell transplants as a very complex process. It is an issue in and of itself, and this isn't something that can be applied to large numbers of people.

During an interview with MNT, Dr. Otto Yang, professor of medicine at the University of California, Los Angeles (UCLA), and associate director of the UCLA's AIDS Institute, agreed that having a fourth person in remission following a stem cell transplant isn't a game changer for HIV researchers, although it's a positive development for the City of Hope patient personally.

I mean, obviously, it's fantastic, right? Dr. Yang said. It's great news, but it's not new news.

Timothy Ray Brown was the first person to achieve long-term HIV remission following a stem cell transplant.

Brown died in 2020 due to recurring leukemia, but he was said to be still in remission from HIV.

Dr. Yang told MNT. That this, in essence, is almost a complete duplicate of the story of the Berliner patient.

A London patient who had HIV was treated with a stem cell transplant to treat Hodgkin lymphoma in 2020 and became the second person to obtain long-term HIV treatment. Along with the Berlin patient, his doctors used cells that did not express CCR5 Delta 32. Individuals with this mutation are resistant to HIV.

Dr. Yang explained that the mutation is related to a mutation in one of the cells' main receptors.

Specialists at Weill Cornell Medicine in New York City announced that an HIV-positive lady had received a stem cell transplant to treat leukemia, which also resulted in a long-term remission of HIV.

According to Dr. Yang, there is a reason for there have only been four patients who had long-term HIV remission following a stem cell transplant in the last 15 years.

There are also a lot of obstacles to making the CCR5 mutation a regular therapy, according to the professor.

The City of Hope patient does demonstrate that long-term HIV remission is possible, according to Dr. Yang. It is also clear that it wasn't a fluke.

HIV illness has a role in the treatment of the illness.

According to Dr. Zaia, this fourth patient is different because to his age, he received reduced-intensity chemotherapy prior to his transplant. This was an older patient, and we have a gentler treatment regimen for the elderly, according to Dr. Zaia.

It's the first time that a person has received this kind of treatment. That demonstrates that you don't have to destroy the whole immune system to get rid of the virus.

Dr. John Zaia is a doctoral scholar at the University of Alabama.

Because people with HIV are living longer due to antiretroviral therapy, knowing how to perform this type of stem cell transplant is important.

Dr. Zaia predicts that as the HIV-positive population ages, they will develop more cancers. This technique might be used in those individuals rather than having to undergo harsher therapy.

Dr. Zaia stressed that the success of the City of Hope patient is also important because it encourages the scientific community to keep pushing.

More people with HIV might receive the treatment if scientific advances continue to make stem cell transplants safer and easier.

It's still unlikely that it will be the answer to curing the world's HIV-positive population, but it'll likely have a role, according to Dr. Zaia.

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