it is one of the very few cases in the world

A man of 53 years old it is totally recovered from HIVthe virus responsible for acquired immunodeficiency syndromebetter known by the acronym of AIDS. It is one of the very few known cases in the world of complete remission from the infection. The patients HIV positivein fact, they have to hire drugs for life, due to the persistence of the pathogen that lurks in the tissues. In other words, the infection is incurable and can only be “held at bay”. However, there are a handful of people who are completely cured thanks to a stem cell transplantwhich became necessary to treat an oncological pathology such as acute myeloid leukemia (LMA).

The first of these healed individuals was the famous “Berlin patient”, a man who has been in complete remission of HIV for a dozen years. Unfortunately he lost his life in 2020 due to leukemia. The second was the “London patient”, which has been in remission for four years. Before the 53-year-old, the last patient to be cured of HIV it had been a 66-year-old man, the oldest of the handful to have had this “luck”. Before him, early last year, instead a middle-aged woman was healed. These patients all have one thing in common: they have had bone marrow transplants bone marrow / stamina cells to fight blood cancer. But not just any stem. The secret of these cells lies in a peculiar genetic mutation call CCR5Δ32which has the ability to modify the expression of the coreceptor CCR5. In very simple terms, it is the anchor point that the HIV virus uses to bind to and invade human cells. In people with this mutation HIV does not “take root” and therefore they turn out protected from the dreaded infection.

But then why not do these mutated stem cell transplants to all AIDS patients (tens of millions in the world)? The reason, as explained by Professor Jana k. Dickter of City of Hope, the research center that treated the 66-year-old, “is not a suitable option for most people with HIV.” The reason lies in the fact that it is a procedure extremely riskywhich temporarily deletes the immune system of a person and can cause very serious side effects. Such risks can be taken to fight a cancer that is going to kill you, but not to treat a disease that, in principle, can be contained with a therapy antiretroviral drugs (ART). This life-saving treatment has been suspended in the few patients who have recovered, with little or no more HIV detection.

In the case of the 53-year-old patient, who received the mutated stem cell transplant in 2011, the virus is no longer detectable in the blood, but traces of DNA appear sporadically by PCR, for example in some tissues and peripheral T-cell subsets. Tested in animal models, however, these viral particles have not shown any replication ability. They also determine a very low immune activation. For this reason, researchers at the University Hospital of Düsseldorf have decided to suspend (with the patient’s approval) antiretroviral therapy starting from 2018. Today he is considered to be in complete remission from HIV, like very few other patients. The details of the research on his case “In-depth virological and immunological characterization of HIV-1 cure after CCR5Δ32/Δ32 allogeneic hematopoietic stem cell transplantation” have been published in the authoritative scientific journal Nature Medicine.