One of the patients successfully treated for HIV received a bone marrow transplant lacking a protective mutation that is thought to have helped others receiving the treatment, Swiss researchers have reported. The findings provide opportunities for research to help more people achieve remission from HIV infection.
So far seven patients across the world are known to be in long term remission from HIV - or to have been cured - through bone marrow transplants.
A patient in Geneva, known as Romuald, is the only one to have received a transplant of stem cells lacking the CCR5Δ32 mutation, researchers report in Nature Medicine. The mutation makes CD4 cells with the natural resistance to HIV.
The research team showed that Romuald’s cells remain vulnerable to HIV infection. However, nearly three years after antiretroviral treatment was stopped, any infection remains undetectable, they report.
The scientists are now speculating about why the patient has fared so well even in the absence of this protective mutation in their donated stem cells.
One possibility is the immunomodulatory treatment they are receiving to control graft-versus-host disease is also preventing reactivation of HIV. Another theory is that graft-versus-host reactions themselves may have effectively eliminated the remaining HIV infection.
The research has been led by Professor Alexandra Calmy, Director of the HIV/AIDS Unit in the Division of Infectious Diseases at Geneva University Hospitals, and Professor Asier Sáez-Cirión, Head of the Viral Reservoirs and Immune Control Unit at the Institut Pasteur, Paris, France.
“These hypotheses open up promising avenues for research aimed at achieving remission for HIV infection,” they state.
Source:
Sáez-Cirión A, Mamez AC, Avettand-Fenoel V, Nabergoj M, Passaes C, Thoueille P, Decosterd L, Hentzien M, Perdomo-Celis F, Salgado M, Nijhuis M, Melard A, Gardiennet E, Lorin V, Monceaux V, Chapel A, Gourves M, Lechartier M, Mouquet H, Wensing A, Picado JM, Yerly S, Rougemont M, Calmy A. (2024) “Sustained HIV remission after allogeneic hematopoietic stem cell transplantation with wild-type CCR5 donor cells.” Nature Medicine, 2 September 2024, doi: 10.1038/s41591-024-03277-z.
Link: https://www.nature.com/articles/s41591-024-03277-z
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