Scientists and medical professionals have long sought a cure for infection by HIV, a potentially deadly virus that affects an estimated 38 million people worldwide.
While antiretroviral therapy (ART) has made significant strides in managing HIV infection, the prospect of a cure still remains elusive. However, recent developments in stem cell therapy suggest that a cure for HIV infection may be possible in the near future.
According to the new study in Nature, a 53-year-old man has become at least the third person with HIV to be declared clear of the virus. Following this success, researchers are taking seriously the possibility of using stem cell transplants and genetic engineering to cure HIV infection.
The story of a German man known as the Düsseldorf patient has reinvigorated the search for an HIV cure and shed light on potential new avenues for HIV research. Here we take a deeper look at the patient’s story and see if it may mean we have found a cure for HIV infection.
A Remarkable Case Study: Stem Cell Transplant Cures HIV Infection
In 2013, the 53-year-old man in Düsseldorf, Germany, underwent a stem cell transplant to treat his Hodgkin's lymphoma.
The transplant was successful and the patient's lymphoma went into remission. However, what made the case remarkable was the fact that the stem cells used for the transplant came from a donor with a rare genetic mutation that makes them immune to HIV infection.
Initial tests following the stem cell transplant showed the patient still had traces of the virus, but that it was not replicating. As HIV stays in the body during ART therapy, the medical team decided to see what would happen if he stopped the therapy altogether.
Remarkably, the patient was able to stop ART therapy and has been essentially HIV-free for over two years—without any rebound in the levels of the virus from their very low levels.
This case sits among several that suggest a cure for HIV infection may be possible through the use of stem cell transplants and genetic engineering. Timothy Ray Brown was the first patient considered cured of HIV in 2008. Like the Düsseldorf Patient, Brown underwent stem cell transplants for cancer from a donor who was immune to HIV infection. Doctors declared Brown cured not long after his transplant.
Another patient, 40-year-old Adam Castillejo, had a bone marrow transplant in 2016 to treat Hodgkin's lymphoma. His donation also came from someone with the mutation and he was declared cured of HIV infection in 2019.
Potential Insights for HIV Cure Research
The cases of the Düsseldorf patient and other patients are painting a bright picture for the future of HIV cure research.
Researchers are exploring using genome editing techniques, such as CRISPR-Cas9, to create a similar genetic mutation in a patient's own stem cells. The modified cells would then be transplanted back into the patient as an autologous transplant.
This approach is attractive as it is much more practical and less risky than using donor cells. Currently, stem cell therapy will likely not be used in HIV patients who don't also have leukaemia due to the complications of using donor cells. Autologous stem cell therapies with modified cells could pave the way for a scalable and cost-effective cure for HIV.
While there is still a long way to go in terms of developing a practical and scalable cure for HIV, this case study has added to the growing base of evidence that shows stem cell transplants are the way forward in eliminating the virus once and for all.
