A 66-year-old man who was diagnosed with HIV in 1988 is said to be free from both the HIV virus and cancer, following a stem cell transplant from an unrelated donor for leukaemia, according to a groundbreaking announcement at the International AIDS Conference in Montreal Canada.
The patient was treated at City of Hope, one of the largest cancer research and treatment organizations in the United States and a leading center for research into diabetes and other life-threatening diseases, said the organization.
The City of Hope patient is believed to be the fourth patient in the world and the oldest to go into long-term HIV remission without antiretroviral therapy (ART) for more than a year after receiving stem cells from a donor with a mutation rare genetics.
“We were thrilled to let him know that his HIV is in remission and he no longer needs to be on the antiretroviral therapy he’s been on for over 30 years,” said Jana K. Dickter, Associate Clinical Professor to the Division of Infectious Diseases at City of Hope who presented the data, said in a press release.
According to City of Hope, the patient received a chemotherapy-based reduced-intensity transplant regimen prior to his stem cell transplant. “Reduced-intensity chemotherapy makes transplant more tolerable for older patients and reduces the risk of transplant-related complications from the procedure,” the organization said in the statement.
The patient received a blood stem cell transplant at City of Hope in early 2019 for acute myeloid leukemia from an unrelated donor who has a rare genetic mutation, homozygous CCR5 Delta 32, City of Hope said. This mutation makes people who have it resistant to acquiring certain strains of HIV.
CCR5 is a receptor on CD4+ immune cells, and HIV uses this receptor to enter and attack the immune system. But the CCR5 mutation blocks this pathway, which prevents HIV from entering cells and therefore from replicating.
The City of Hope patient has shown no evidence of HIV virus replication since the transplant, the organization said.
“We are proud to have played a part in helping the City of Hope patient achieve remission from HIV and leukemia. It is humbling to know that our pioneering science in bone marrow and stem cell transplants, along with our search for the best precision medicine in cancer, has helped transform this patient’s life,” said Robert Stone, president and CEO of City of Hope, in a statement.
While the announcement gives hope to millions of people living with HIV, medical experts have warned that a procedure like this is not a viable cure for the virus.
Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, urged caution in February after researchers announced that an American woman had been cured of HIV after undergoing a new transplant procedure using donated umbilical cord blood.
“It’s not practical to think that this is something that’s going to be widely available,” Fauci said. “It’s more of a proof of concept.”
Because bone marrow transplantation is a dangerous and risky procedure, it is considered unethical to perform it on people living with HIV, unless the person also has cancer and needs a transplant as part of his cancer treatment.
Despite the fact that it is not a practical and applicable cure for HIV on a large scale, incredible progress has been made in HIV treatment and innovation over the years, which allows people living with HIV to lead a normal and healthy life.
Known as U=U, or Undetectable=Untransmittable, if an HIV-positive person begins appropriate HIV treatment, takes it daily, and brings the virus in their body to an undetectable level, the individual cannot transmit the virus to someone as long as their virus levels remain undetectable on said treatment or medication.
In December 2021, the United States Food and Drug Administration approved the first long-acting injectable drug for HIV prevention.
Until now, the only medications authorized and approved by the FDA for HIV prevention or pre-exposure prophylaxis, more commonly known as PrEP, have been daily pills, which prevent HIV from entering cells in the body and therefore prevent the infection. When taken as prescribed, PrEP services reduce the risk of contracting HIV through sex by about 99%, according to new data from the CDC.
Post-exposure prophylaxis or PEP is a less reliable, though still very effective, way of preventing HIV infection. These pills are meant to be taken immediately or within 72 hours if someone has been exposed or potentially exposed to HIV to try to stop the virus from entering immune cells causing infection. It is like an emergency pill for HIV prevention and must be taken daily for 28 days.
Now people who feel at risk of HIV infection have the option of taking the daily pill, or the new shot every two months, after two initiation shots given a month apart.
On the vaccine front, Moderna recently announced the launch of early clinical trials of an mRNA vaccine against HIV. ABC News previously reported that the biotech company partnered with the nonprofit International AIDS Vaccine Initiative to develop the vaccine, which uses the same technology as Moderna’s blockbuster COVID-19 vaccine.
ABC News’ Eric Strauss, Sony Salzman and Jennifer Watts contributed to this report.