• Posted July 19, 2024

German Patient is 7th Person Probably Cured of HIV

A German man has become the seventh person to apparently be cured of HIV, researchers report.

The 60-year-old man, referred to as the “next Berlin Patient,” was treated with a stem cell transplant in October 2015 for acute myeloid leukemia, researchers said.

He stopped taking the antiretroviral drugs needed to suppress HIV in September 2018, but has not developed any detectable levels of the AIDS-causing virus in the nearly six years since, researchers said.

“A healthy person has many wishes, a sick person only one,” the man, who has chosen to remain anonymous, said in a statement.

The man’s case offers new insight into a potential HIV gene therapy cure for all, his doctors say.

Prior HIV cure cases have been similar in that the patients all received a stem cell transplant following their diagnosis for a blood cancer like leukemia.

The HIV cure occurred because the stem cell donors for these patients had naturally inherited two copies of CCR5-delta32, a mutation of the CCR5 white blood cell gene.

This genetic mutation renders people essentially immune to HIV by blocking the retrovirus’ ability to infiltrate immune cells, researchers explained.

The next Berlin Patient is the first HIV cure case in which the donor had inherited just one copy of CCR5-delta32, researchers said. People with one copy can become infected with HIV, but the virus generally progresses slowly.

“We couldn’t find a matching stem cell donor who was immune to HIV, but we did manage to find one whose cells have two versions of the CCR5 receptor: the normal one, and then an extra, mutated one,” said Dr. Olaf Penack, a senior physician at Charité-Universitätsmedizin Berlin, the hospital that treated the man.

Significantly more people have one copy of this mutation than two, meaning that future HIV patients with blood cancers might have a better chance of receiving a cure, researchers said.

“We’re very pleased that the patient is in good health and doing well,” Penack said. “The fact that he has been under observation for more than five years and has been virus-free the whole time indicates that we did indeed succeed in completely eradicating HIV from the patient’s body. So we consider him cured of HIV.”

The case is scheduled to be presented this week at the 25th International AIDS Conference in Munich by Dr. Christian Gaebler, a physician-scientist at Charité-Universitätsmedizin Berlin.

“It’s extremely surprising that the patient was cured even though the stem cell donor wasn’t immune to HIV,” Gaebler noted in a hospital news release. “In previous stem cell transplantation cases involving donors who were not immune, the virus resumed replicating after a few months.”

The same hospital treated the first known HIV cure by stem cell transplantation, in a man who became known as the "Berlin Patient" when his case was announced in 2008.

“The next Berlin Patient’s experience suggests that we can broaden the donor pool for these kinds of cases, although stem cell transplantation is only used in people who have another illness, such as leukemia,” said Sharon Lewin, president of the International AIDS Society.

“This is also promising for future HIV cure strategies based on gene therapy, because it suggests that we don’t have to eliminate every single piece of CCR5 to achieve remission,” Lewin added in a meeting news release.

However, it also could mean that the CCR5 mutation has nothing to do with the HIV cure, Gaebler said.

If that’s the case, then the second Berlin Patient was cured because the donor’s “transplanted immune cells eliminated all of the patient’s HIV-infected cells,” Gaebler said.

“By replacing his immune system, we apparently destroyed all the places where the virus was hiding, so it was no longer able to infect the new immune cells from the donor,” Gaebler explained.

Stem cell transplants are dangerous procedures in which chemotherapy is used to kill off a person’s bone marrow in preparation for the new cells.

Because of this, they are typically available only for HIV patients who also develop a blood cancer or some other illness that can be treated through a stem cell transplant.

“This kind of … stem cell transplant is an extremely complex procedure associated with a mortality rate of about 10%. As a result, it is used only in severe cases,” Charité-Universitätsmedizin Berlin said in its statement.

More information

The U.S. Centers for Disease Control and Prevention has more about HIV treatment.

SOURCE: International Aids Society, news release, July 18, 2024; Charité-Universitätsmedizin Berlin, news release, July 18, 2024