October 3, 2022

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HIV disappeared after the patient received stem cell transplant

HIV disappeared after the patient received stem cell transplant



 

HIV disappeared after the patient received stem cell transplant.

The world’s third case of AIDS cured patients appeared? HIV disappeared from her body after stem cell transplant. 

AIDS (HIV) is short for Acquired Immune Deficiency Syndrome , caused by infection with the HIV virus . HIV is a virus that can attack the human immune system.

It takes the most important CD4+ T cells in the human immune system as the main target of attack, and destroys the cells in large quantities. The development of AIDS patients will cause the body to lose its immune function.

Due to the extreme decline in resistance, various infections will occur. In the later stage, malignant tumors often occur, and even systemic failure leads to death.

 

According to the United Nations Programme on HIV/AIDS, there are currently 38 million people living with HIV and AIDS worldwide, and more than 35 million people have died accumulatively.

However, an effective AIDS vaccine has not yet been developed, and existing antiretroviral drugs (ART) can only suppress the virus, but cannot clear the HIV virus or cure AIDS.

 

On February 15, 2022, a team of researchers from UCLA and Johns Hopkins University presented an HIV treatment case at the Conference on Retroviruses and Opportunistic Infections (CROI) : A man receiving cord blood stem cell transplantation Female AIDS patients with acute myeloid leukemia have been HIV-undetectable for up to 14 months after stopping AIDS medication.

 

This is the third case after the ” Berlin Patient ” and the ” London Patient ” who achieved long-term remission of AIDS through stem cell transplantation .

 

The study was the International Maternal/Child/Adolescent HIV Clinical Trials Network (IMPAACT) P1107 observational study, led by Dr. Yvonne Bryson of UCLA and Dr. Deborah Persaud of Johns Hopkins University.

The study, started in 2015, was designed to observe disease progression in 25 HIV-infected individuals who received CCR5 Δ32/Δ32 cord blood stem cell transplants for cancer, hematopoietic disorders, or other conditions.

 

CCR5 is a receptor for HIV virus to invade and infect human cells. After CCR5 Δ32/Δ32 gene mutation, cells lack CCR5 receptor, and HIV virus cannot infect.

For leukemia patients infected with HIV virus, the cancer cells are first killed by chemotherapy, and the hematopoietic stem cells with CCR5 gene mutation are transplanted.

It is possible to cure the leukemia while making the HIV virus in the patient unable to infect, so as to gradually eliminate the HIV virus and achieve Long-term remission, or even cure, of AIDS.

 

The woman had been on AIDS antiretroviral (ART) therapy for 4 years when she was diagnosed with acute myeloid leukemia .

After chemotherapy, her leukemia went into remission. Before the stem cell transplant, her HIV was well controlled, but HIV was detectable.

In 2017, she received a CCR5 Δ32/Δ32 cord blood stem cell transplant , and 100 days after the transplant, the stem cells were successfully engrafted, and the HIV virus was undetectable in the body.

At 37 months post-transplant, she stopped antiretroviral (ART) medication.

Up to 14 months after stopping treatment, the HIV virus is still undetectable in the patient’s body, that is, stem cell transplantation achieves long-term remission of AIDS.

 

Prior to this, a total of 2 AIDS patients achieved long-term remission, or “cure” of AIDS through this stem cell transplantation, namely the ” Berlin patient ” and the ” London patient “, the former was a white male, the latter was a A Latino male.

 

The Berlin patient is widely known. For a long time, he was the only cured AIDS patient on the planet. His name was Timothy Ray Brown .

He was found to have AIDS in 1995 and has been receiving antiretroviral therapy (ART) since then . In 2006, he suffered from acute myeloid leukemia .

In 2007, he received CCR5 Δ32/Δ32 hematopoietic stem cell transplantation, which not only cured the leukemia, but also completely disappeared the HIV virus in the body.

After 12 years, he did not detect the HIV virus, so he was considered cured of AIDS. In September 2020, he died of a relapse of leukemia.

 


“Berlin Patient,” Timothy Ray Brown

 

 

For a long time, the Berlin patient was the only AIDS patient to be cured, until March 5, 2019.

On this day, Nature published a paper titled: HIV-1 remission following CCR5Δ32/Δ32 haematopoietic stem-cell transplantation .

 

HIV disappeared after the patient received stem cell transplant

 

A HIV-infected Hodgkin lymphoma patient who received CCR5 Δ32/Δ32 hematopoietic stem cell transplantation was effectively treated for Hodgkin lymphoma, and at the same time, for up to 30 months, he did not have HIV was detected again.

 

 

“The London Patient” by Adam Castillejo

 

 

On March 10, 2020, the Lancet HIV journal published a paper that after 4 consecutive years of follow-up study of the “London patient” after treatment, the improvement of his condition was changed from long-term remission to cure. Announced the emergence of the world’s second completely cured AIDS patient .

 

HIV disappeared after the patient received stem cell transplant

 

The third case of long-term remission of AIDS after stem cell transplantation suggests that CCR5 Δ32/Δ32 stem cell transplantation should be considered to achieve remission and cure in this HIV-infected patient who requires hematopoietic stem cell transplantation for other diseases.

 

In addition, in August 2020 and November 2021, Professor Xu Yu of Harvard Medical School discovered two cases of AIDS patients who had achieved self-healing without stem cell transplantation and other treatments , and called them ” San Francisco patients ” and ” Egyptian patients” respectively.

Speranza Patient “. Both are elite controllers, and their own immune systems are powerful enough to suppress HIV and keep it within safe limits without the need for medication.

These two can be described as the elite of the elite controllers, and the HIV virus has been eliminated by their own immune system alone.

 

On September 11, 2019, the team of Deng Hongkui of Peking University, the team of Chen Hu of the Fifth Medical Center of the PLA General Hospital , and the team of Wu Hao of Beijing You’an Hospital affiliated to Capital Medical University jointly published a research paper in the New England Journal of Medicine (NEJM) . .

 

In this clinical trial, CCR5 gene editing was performed on human adult hematopoietic stem cells using CRISPR gene editing technology, and the long-term stable hematopoietic system reconstruction of the gene-edited adult hematopoietic stem cells was realized in the human body.

A 27-year-old man with AIDS and acute lymphoblastic leukemia was then treated . After treatment, the patient’s acute lymphoblastic leukemia achieved complete morphological remission, and the patient’s T cells showed resistance to HIV virus to a certain extent, and no off-target effects and side effects were found.

 

HIV disappeared after the patient received stem cell transplant

 

 

This gene editing is carried out on adult hematopoietic stem cells, so it will not affect other tissues and organs and the reproductive system.

This preliminary demonstration of the feasibility and safety of gene-edited adult hematopoietic stem cell transplantation in humans will promote and promote the development of gene editing technology in clinical applications.

 

 

 

Reference link :
https://www.nature.com/articles/s41586-019-1027-4
https://doi.org/10.1016/S2352-3018(20)30069-2
https://www.nejm.org/doi/full/10.1056/NEJMoa1817426?query=featured_home

HIV disappeared after the patient received stem cell transplant

(source:internet, reference only)


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