A patient in remission from HIV infection since 32 months

Prof. Alexandra Calmy, Head of the HIV Unit in the Division of Infectious Diseases at Geneva University Hospitals (HUG) and Vice-Dean of the Faculty of Medicine at the University of Geneva (UNIGE), and Prof. Asier Sáez-Cirión, Head of the Viral Reservoirs and Immune Control Unit at the Institut Pasteur, have published an article in the journal Nature Medicine detailing the case of a patient in remission from HIV infection following a bone marrow transplant for the treatment of blood cancer.

Photo: Istock.

Worldwide, seven people (two in Berlin, one in London, one in Düsseldorf, one in New York, one in City of Hope and one in Geneva) are considered likely to have been cured of HIV infection after receiving a bone marrow transplant to treat blood cancer.

The particularity of the Geneva patient, followed at the HUG in collaboration with the Institut Pasteur, the Institut Cochin and the IciStem consortium, lies in the fact that the transplant was obtained from a donor who did not carry the CCR5 delta 32 mutation. In the other cases, the transplant came from a donor carrying at least one copy of this rare genetic mutation known to make CD4 cells naturally resistant to HIV. Despite this, the virus remains undetectable, almost three years after antiretroviral treatment was stopped.

A reduction in the viral reservoir

Close and prolonged monitoring of this patient has enabled the research teams to demonstrate a progressive reduction in the viral reservoir following the transplant. Virus-carrying cells capable of multiplying, which were easily detected before the transplant, are no longer detectable in the latest analyses.

The article details these results, as well as the hypotheses that teams from the UNIGE, the HUG and the Institut Pasteur are working on to try to explain the remission in this exceptional patient. The presence of immune system cells capable of fighting HIV effectively could prevent the virus from reappearing, even if there are still a few infected cells in the body. In addition, the immunomodulatory treatment that the patient receives following his transplant could help to prevent viral reactivation. These hypotheses open up important avenues of research with a view to one day achieving remission, or even a cure, for HIV.

A Press release dated 20 July 2023 details the history of this patient.

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