“When I was diagnosed with HIV in 1988, like many others, I thought it was a death sentence. I never thought I would live long enough to see the day I would never have the virus again.” These are the words of the patient from the “City of Hope”, as he was nicknamed by borrowing the name of the hospital where he was treated, the City of Hope National Medical Center in Duarte, California. This is the fourth person in the world who appears – caution is a must – to have completely defeated the HIV virus.
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The 63-year-old man, who prefers to remain anonymous, has lived with HIV for over 30 years, precisely since 1988, the year he received the terrible diagnosis. For more than half of his life, he was forced to follow antiretroviral therapy, which allows HIV-positive people to keep the virus under control, ward off AIDS and thus have an almost normal life expectancy. Instead, he has been in remission for over 17 months: there is no trace of HIV in his blood, despite the fact that he has stopped taking his drugs.
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The crucial factor was the bone marrow transplant he underwent to treat a form of leukemia. Only later, by chance, did the doctors discover that the bone marrow donor is one of those people who are naturally resistant to the HIV virus. The case was presented at the 2022 International AIDS Conference in Montreal, Canada.
Today the patient says he is “very grateful” for his alleged recovery. Many of his friends weren’t as lucky and died of HIV, when it was not yet known that antiretroviral drugs could help these people keep the infection at bay. To control it, but not to heal it.
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The HIV virus damages the body’s immune system and this can lead to AIDS. The virus enters our body’s white blood cells using a microscopic gate, a protein called CCR5. However, some people, including the donor, have CCR5 mutations that block this port and keep the virus out. “In this way the treated patient repopulated the organism with immune cells that could no longer be infected”, explains Giovanni Magadirector of the Institute of Molecular Genetics of the National Research Council and author of the book Aids: the truth denied (The Scientific Thought Publisher). “So the body naturally eliminated the last reservoirs that forced this person, like all infected people, to take antiretroviral therapy,” he adds.
After 30 years he stopped the therapy
Even the man’s doctors are over the moon over the unexpected recovery. “We were thrilled to let him know that his HIV is in remission and that he no longer needs to take the antiretroviral therapy he had been on for over 30 years,” he reports. Jana Dickteran infectious disease physician at the City of Hope National Medical Center.
This is the oldest patient among the recovered
Of cases like these only 3 others have been documented worldwide. The first is that of the “Berlin patient”, Timothy Ray Brown healed in 2011. The City of Hope patient is the oldest of the “4 healed” to be treated in this way and is also the one who lived with the virus for more time. However, this good news must be received with great caution. “It is clear that this approach cannot be proposed on a large scale”, Maga points out. Not all 38 million people in the world currently infected can have a bone marrow transplant. “It’s a complex procedure with potentially significant side effects,” says Dickter. “So, it’s not really a suitable option for most people living with HIV,” she adds.
Objective: to hit CCR5
Now researchers are looking for ways to target CCR5 using gene therapy as a potential treatment. “The value of cases like these – comments Maga – is that once again it is shown that by making our immune system resistant to infection or by strengthening it so that it can more effectively eliminate those few infected cells that regenerate daily, we can hope to completely eradicate the infection. Hence ideas for new approaches, such as gene therapy, therapeutic vaccines or increasingly powerful drugs that perhaps one day will allow the virus to be eradicated “. We are still far from the desired goal. “A cure remains the Holy Grail of research,” he comments Sharon Lewinelected president of the International Aids Society.