Introduction

A man known as the “Geneva Patient” entered a long stage of recovery from AIDS after a bone marrow transplant that did not reveal a mutant that prevented the virus from entering cells, unlike what had been reported in similar previous treatments.

Opening Doors for Research

This announcement is likely to open doors for research in this regard.

This patient’s case was presented on Thursday in Brisbane ahead of the opening of Sunday’s International AIDS Society conference in Australia.

Previous Cases of Cured HIV Patients

Five people before him were considered cured of HIV after a bone marrow transplant. All of the patients who recovered had a particular common condition, that is, they had leukemia, and they received stem cell transplants that radically rejuvenated their immune systems.

But each time, the donor had a rare mutation in a gene known as CCR5 delta 32, a genetic mutation known to prevent HIV from entering cells.

Different Case of the “Geneva Patient”

As for the “Geneva patient”, the situation is different here: in 2018, he received a stem cell transplant to treat a very dangerous form of leukemia, but this time the transplant was received from a donor who is not a carrier of the CCR5 mutation.

Thus, unlike the cells of others classified as recovered, donor cells from the “Geneva patient” theoretically do not prevent HIV from replicating.

Recovery of the “Geneva Patient”

However, 20 months after the cessation of antiretroviral therapy, the presence of the virus was not detected in this patient, who was monitored by the University of Geneva hospitals in collaboration with the Pasteur Institute, the Cochenin Institute, and the international coalition “IciStem”.

His antiretroviral therapy was gradually tapered and he was permanently discontinued in November 2021.

Tests carried out within 20 months of stopping treatment did not reveal any viral particles, reactive virus stock, or enhancement of the immune response against the virus in this patient.

The scientific teams have not ruled out that the virus is still present, but considered that this patient’s condition represented a new recovery from HIV.

Past Attempts without the Protective Mutant

Bone marrow transplantation without the protective mutant had previously been performed for other HIV-infected patients prior to the Geneva patient.

“The virus reappeared a few months later,” said Asier Saez Sirion, head of viral stocks and immune control at the Pasteur Institute.

“We believe that going more than 12 months without detecting a virus greatly increases the likelihood that it will go undetected,” he added.

Possible Explanations

There are several hypotheses that explain this phenomenon in the “Geneva patient”.

“In this particular case, the transplant could have killed all the affected cells without the need for protective mutants,” Saez-Sirion said, “or perhaps his immunosuppressive therapy required after transplantation played a role in this.”

Cautious Optimism

While Sharon Levine, president of the Society’s International Conference on AIDS, acknowledged that this long recovery was “encouraging,” he warned that “a single virion (infectious viral particle) can lead to the recovery of the virus.”

He added that this patient “would need to be closely monitored over the next few months or even years…and it is impossible to predict the likelihood of recovery.”

Challenges of Bone Marrow Transplantation

While these recoveries raise hopes of one day overcoming HIV, bone marrow transplantation remains difficult and risky, and is not suitable for most HIV carriers.

In any case, the researchers felt that this “exceptional” case opened up new avenues for research, such as the role that immunosuppressive therapy might play.

A Miracle Recovery

The patient, who has been living with HIV since the early 1990s, does not wish to reveal his name at this time, as this recovery is considered a miracle that puts him at the service of the future and research.

Source

Source: AFP.