A German resident could be part of a medical breakthrough after he was apparently cured of HIV, a feat accomplished by only six people worldwide in more than four decades since the start of the AIDS epidemic.
The German, who preferred to remain anonymous, was treated for acute myeloid leukemia (AML) with a stem cell transplant in October 2015. He stopped taking his antiretroviral drugs, which are taken as a treatment to keep HIV levels low, in September 2018.
The man remained in “viral remission,” meaning repeated tests detected no traces of HIV in his body.
In a statement about his condition, the man said: “A healthy person has many wishes, a sick person has only one.”
The case is expected to be presented soon at the International AIDS Conference in Munich.
The man is the seventh person in the world to have been cured of the virus. However, experts have tempered the enthusiasm by warning that the treatment undergone by carriers of the virus will be accessible to only a few: all the patients contracted the virus and then developed blood cancer that required a stem cell transplant to treat the malignancy.
Bone marrow donors had immune cells with a rare resistance to the HIV virus, which likely helped eliminate all copies of the virus in the patients’ bodies.
The difficulty of curing HIV
The HIV virus is difficult to cure, in part because it creates many mutations that make it difficult to develop an effective vaccine. In addition, some of the cells infected with HIV are “dormant” immune cells that do not destroy the virus. Carriers must take antiretroviral drugs that inhibit the replication of the virus but do not completely eliminate it.
In five of the seven cases of definite or possible cures for HIV, doctors found bone marrow donors with rare, naturally occurring defects in both copies of a gene that creates a certain protein called CCR5 on the surface of immune cells. Most strains of HIV attach to this protein to infect cells. Without functioning CCR5 proteins, immune cells are resistant to HIV.
The German’s donor had only one copy of the CCR5 gene, meaning his immune cells likely contained about half the normal amount of the protein. In addition, he had only one copy of the gene itself. Together, these two genetic factors may have increased his chances of recovery.
Although it is rare to have two copies of the defective CCR5 gene (occurring in about 1% of people of Northern European descent), one copy is present in about 16% of such people.
Who are the other six people cured of HIV?
The other six patients who are believed to have been cured of the virus include Timothy Ray Brown, known as the “Berlin patient,” who was the first man reported to have been cured of HIV.
Brown, an American living in Germany, was treated for AML cancer. He was cured of HIV but died of recurrent leukemia in 2020.
Adam Castillejo, known as the “London Patient”, is a Venezuelan of origin who lives in England. He received a stem cell transplant for blood cancer. In 2016, he stopped taking HIV medication and was also considered cured.
Marc Franke, known as the “Düsseldorf patient,” was treated with a stem cell transplant for AML blood cancer in 2013. Franke, 55, stopped taking antiretroviral drugs for HIV in November 2018 and is considered healthy.
Paul Edmonds, known as the “City of Hope patient,” is the oldest of the cured patients, at 63. He received a bone marrow transplant in 2019 and has been off HIV medication since March 2021.
Next year, five years after he stopped taking HIV treatment, he will be considered completely cured. He said he was excited by the latest case of someone apparently cured, saying: “My vision is clear: a world where HIV is no longer a sentence but a footnote in history.”
“The New York patient” is another woman who was diagnosed with leukemia in 2017 and received a stem cell transplant from umbilical cord blood.
The “Geneva patient” is a man in his fifties who was diagnosed with a rare blood cancer in 2018 and who has not received HIV treatment since November 2021 after also receiving a bone marrow transplant. In this case too, doctors are cautious and wait until the fifth year without HIV treatment to declare him cured.
