Researchers Announce Two New Probable HIV Cure Cases

Two people—the Chicago and Oslo Patients—have potentially been cured of HIV via stem cell transplantation with donor cells that harbor the CCR5-delta 32 mutation, which makes them almost impervious to infection by most strains of HIV. This transplantation procedure has been successful in curing five other individuals of HIV, with a sixth yet to be confirmed. (Two other cases used donor cells that were not HIV-resistant.)

The two new cases were presented on March 10 at the annual Conference on Retroviruses and Opportunistic Infections.

“The Chicago and Oslo Patients remind us that while the HIV reservoir can be resilient, the infected cells that hide out in the body are ultimately vulnerable and can be eradicated,” said Dr. Andrea Gramatica, amfAR VP and director of research. “While any report of a potential HIV cure is good news, long-term follow-up in these two cases is necessary to confirm permanent eradication of the virus.”

Paul Rubinstein, MD, of the University of Illinois at Chicago, shared study results detailing the Chicago Patient, a 67-year-old man who underwent a stem cell transplant for acute myeloid leukemia with HIV-resistant donor cells.

The research team, which includes past amfAR grantees Drs. Eli Boritz and Brandon Keele, was not able to detect HIV in circulating cells in the blood or bone marrow after more than a year of monitoring post-transplant.

At 15 months, the team decided to interrupt antiretroviral therapy (ART) to determine whether the virus had been successfully eradicated. When treatment was stopped, however, HIV rebounded—according to the researchers, HIV replication-competent cells that lay dormant in the man’s viral reservoir reactivated.

Eager to ascertain if a cure was still possible, the researchers restarted ART and stopped treatment after two years. This time, the man has been able to achieve HIV remission for 10 months and counting. It marks the first known case of sustained treatment-free HIV remission after HIV rebound post-transplant.

Marius Trøseid, MD, PhD, a physician at Oslo University Hospital in Norway, presented the case of the Oslo Patient, a 58-year-old man who had been living with HIV for 14 years. Diagnosed with a blood disorder called myelodysplastic syndrome, he received a stem cell transplant with HIV-resistant cells donated by his brother. The transplant recipient, whose cells were not HIV-resistant, stopped treatment 24 months after the procedure and has been in remission for 48 months—the first case of remission using a sibling’s donor cells.

The research team includes past amfAR grantees Dr. Martin Tolstrup and Ole Søgaard, and members of the amfAR-established IciStem research consortium, Drs. Maria Salgado and Javier Martinez-Picado.

The study considered various possible mechanisms that led to the remission. For example, the individual developed severe acute and prolonged graft-versus-host disease (GvHD), a significant complication post-transplant in which a donor’s immune cells attack a recipient’s cells, and was treated with immunosuppressive drugs. One of these drugs and GvHD may reduce the HIV reservoir.

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