Fifth “Curer” appeared: Special stem cell transplantation successfully “cured” an AIDS patient
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Fifth “Curer” appeared: Special stem cell transplantation successfully “cured” an AIDS patient.
Exciting: Special stem cell transplantation successfully “cured” an AIDS patient, and the world’s fifth “curer” appeared.
AIDS (HIV)is the abbreviation of Acquired Immunodeficiency Syndrome , which is 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 attack target, destroys the cells in large numbers, and develops after a incubation period of several years or even as long as 10 years or longer As an AIDS patient, the human body loses its immune function.
Due to the extreme decline of resistance, various infections will occur. Malignant tumors often occur in the later stage, and even the whole body fails and dies.
According to UNAIDS data, the number of HIV carriers and AIDS patients in the world is as high as 38 million , and has caused more than 35 million deaths. However, no effective AIDS vaccine has been developed so far, and the existing antiretroviral drugs (ART) can only suppress the virus, but cannot eliminate HIV virus or cure AIDS.
On February 20, 2023, researchers from Dusseldorf University Hospital and other institutions in Germany published a paper entitled: In-depth virological and immunological characterization of HIV-1 cure after CCR5Δ32/Δ32 allogeneic hematopoietic stem in the top international medical journal Nature Medicine The paper on cell transplantation [1] .
The paper reports a patient who received allogeneic hematopoietic stem cell transplantation for leukemia and demonstrated sustained HIV-1 suppression 9 years after transplantation and 4 years after suspension of antiretroviral therapy.
Even with the most accurate tests, the team could not detect the presence of HIV-1 in him, a condition most experts consider a ” cure .”
This means that following the ” Berlin Patient “, ” London Patient “, ” New York Patient ” and ” City of Hope Patient “, the fifth patient who achieved long-term remission of AIDS through stem cell transplantation – the Dusseldorf patient appeared.
Among them, the treatment of the Berlin patient and the London patient has been described in detail in the medical literature, while the New York patient and the City of Hope patient were reported at a medical conference and have not yet been published in a medical journal.
Allogeneic hematopoietic stem cell transplantation (HSCT) is a treatment for certain cancers, such as leukemia, that repopulates the recipient’s bone marrow by transplanting immature blood cells from a donor.
CCR5 is the 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, chemotherapy is used first to kill cancer cells, and transplantation of hematopoietic stem cells with mutations in the CCR5 gene may cure leukemia while preventing the HIV virus from infecting the patient, thereby gradually eliminating HIV virus and achieving Long-term remission, even cure, of AIDS.
The fifth cured patient – the Düsseldorf patient
In this Nature Medicine paper, the 53-year-old male AIDS patient was diagnosed with acute myeloid leukemia (AML) in January 2011 , and he received CCR5 Δ32 from a female donor in February 2013 /Δ32 stem cell transplantation followed by chemotherapy and donor lymphocyte infusion.
After the stem cell transplant, he continued to receive antiretroviral therapy, but proviral HIV-1 was no longer detectable in the patient’s blood cells.
In November 2018, nearly six years after the stem cell transplant, he agreed to stop antiretroviral therapy , To see if there will be a rebound of the virus. The research team did not observe HIV-1 RNA rebound, or a surge in the immune response to HIV-1 protein.
Although allogeneic hematopoietic stem cell transplantation (HSCT) is a high-risk therapy currently only available to some patients with both HIV and blood cancers, these results may inform future strategies to achieve long-term HIV remission.
The fourth cured patient— a City of Hope patient
The patient was dubbed the ” City of Hope Patient ” after the City of Hope National Medical Center in the United States where he was treated. On July 27, 2022, the research team of City of Hope (City of Hope) announced that a 66-year-old AIDS patient was “cured” .
The patient, who was diagnosed with HIV-1 in 1988, has since developed leukemia and received a bone marrow transplant in 2019, 31 years after he was infected with HIV-1 A long time ago, the bone marrow donor had a rare genetic mutation—deletion of the CCR5 Δ32/Δ32 gene.
After bone marrow transplant treatment, his leukemia and AIDS were completely remitted. As of July 2022, he had stopped taking antiretroviral drugs for more than 17 months, and doctors did not find any signs of HIV-1 virus replication.
The patient is also the oldest patient to be cured of AIDS so far, and his cure has brought new hope to the elderly who suffer from both AIDS and cancer.
The third cured case – the New York patient
On February 15, 2022, at the Conference on Retroviruses and Opportunistic Infections (CROI), a UCLA and Johns Hopkins team reported a case of HIV treatment: a patient treated with a cord blood stem cell transplant HIV-free HIV for up to 14 months after discontinuation of antiretroviral drug therapy in women with acute myeloid leukemia.
The study was an observational study of the International Maternal/Pediatric/Adolescent AIDS Clinical Trials Network (IMPAACT) P1107 study led by Yvonne Bryson, PhD, UCLA, and Deborah Persaud, PhD .
The study, which began in 2015, aimed to observe the disease progression of 25 HIV-infected individuals after receiving CCR5 Δ32/Δ32 umbilical cord blood stem cell transplantation for cancer, hematopoietic diseases or other diseases.
The woman had been on AIDS antiretroviral (ART) therapy for four 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 CCR5 Δ32/Δ32 umbilical cord blood stem cell transplantation . After 100 days of transplantation, these stem cells were successfully implanted, and HIV virus was no longer detectable in the body.
37 months after the transplant, she stopped her antiretroviral (ART) medication. For up to 14 months after stopping treatment, the HIV-1 virus remained undetectable in the patient’s body, that is, stem cell transplantation achieved long-term remission of AIDS.
The second cured case – the London patient
On March 5, 2019, Nature published a paper entitled: HIV-1 remission following CCR5Δ32/Δ32 haematopoietic stem-cell transplantation [2] .
After receiving CCR5 Δ32/Δ32 hematopoietic stem cell transplantation, this Hodgkin’s lymphoma patient infected with HIV-1 virus has been effectively treated. At the same time, for as long as 30 months, he has HIV-1 virus was no longer detected in the body.
On March 10, 2020, the Lancet HIV journal published a paper [3] , after a 4-year follow-up study of the ” London patient ” after treatment, the improvement of his condition was changed from long-term remission to cure. The world’s second cured AIDS patient was announced .
The first cured person – the Berlin patient
The Berlin patient is widely known. For a long time, he was the only person on the planet who was cured of AIDS. His name was Timothy Ray Brown .
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-1 virus in his body.
For more than ten years since then, he has not detected the HIV virus again, and is considered to be the first cured AIDS patient in the world . In September 2020, he died of leukemia relapse.
Self-healing elite controller
There are a very small number of lucky HIV-1 virus-infected people. After they are infected with HIV-1 virus, although they carry the virus in their body for a long time, they can spontaneously inhibit the replication of these viruses and control the number of viruses within a safe range.
These people can control the HIV virus in their body without treatment, so they don’t get sick. They are also called ” elite controllers “.
In August 2020 and November 2021, the team of Professor Xu Yu from Harvard Medical School published papers in the journals of Nature and Annals of Internal Medicine respectively [4, 5] .
Professor Xu Yu ‘s team discovered two cases of AIDS patients who had achieved self-healing without treatment such as stem cell transplantation , and called them ” San Francisco patients ” and ” Esperanza patients “. Both men were elite controllers, their own immune systems capable of suppressing the HIV virus to a safe level without drug treatment.
These two people can be called the elite among the elite controllers. Without receiving treatment, the HIV-1 virus in the body miraculously disappeared, that is, the elimination of the HIV-1 virus was achieved only by their own immune system.
Paper link :
1. https://nature.com/articles/s41591-023-02213-x
2. https://www.nature.com/articles/s41586-019-1027-4
3. https://doi.org/10.1016/S2352-3018(20)30069-2
4. https://www.nature.com/articles/s41586-020-2651-8
5. https://www.acpjournals.org/doi/10.7326/L21-0297
6. https://www.nejm.org/doi/full/10.1056/NEJMoa1817426
Fifth “Curer” appeared: Special stem cell transplantation successfully “cured” an AIDS patient
(source:internet, reference only)
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