The “French Patient” May Be the Latest Person Cured of HIV

A new case of a possible HIV cure—a woman in her mid-fifties living in France—was presented by Olivia Zaegel-Faucher, MD, of the Public Hospital of Marseille, and colleagues at the recent HIV Drug Therapy Glasgow conference.

Referred to as the “French Patient” as her name has not yet been disclosed, the woman was diagnosed with HIV in 1999. She initiated antiretroviral therapy (ART) early and first achieved an undetectable viral load in 2010. In July 2020, she received a stem cell transplant to treat acute myeloid leukemia, which had been diagnosed in February of that year.

Similar to five other cure cases (Timothy Ray Brown, the City of Hope Patient, Marc Franke, Adam Castillejo, and the New York Patient), the French Patient received donor cells with a double CCR5-delta32 mutation, which renders cells almost impervious to HIV infection.

Two other cases involved stem cell transplants but with a difference—the Geneva Patient received wild-type donor cells, which have intact CCR5 receptors, and the Second Berlin Patient received donor cells with only a single “heterozygous” gene mutation for CCR5.

Researchers monitored the French Patient for months after the transplant and were unable to find HIV RNA or DNA in circulating CD4 cells or blood plasma.

The case of the French Patient has been marked by some challenges post-transplant. The stem cells of donor and recipient were not a close match so, along with a pre-transplant conditioning drug regimen, the patient received extra chemotherapy drugs to prevent graft versus host disease (GVHD), a condition in which the donor cells attack the recipient’s body post-transplant. She did develop GVHD, but it resolved swiftly.

In addition, CD4 and CD8 counts at first remained low and then suddenly increased in the summer of 2021, coinciding with HIV antibodies declining slightly over time. As the patient’s immune system rebounded, an analytic treatment interruption (ATI) was suggested to see if her HIV was indeed in remission and she elected to stop ART in October 2023. Aside from a bout of pneumococcal meningitis, from which she recovered, she has not had any significant adverse events post-ATI and has maintained an undetectable viral load for a year. Scientists will continue to monitor her and, if the virus continues to be undetectable and her blood cells remain free of HIV DNA, she will become the eighth person and second woman to be cured of HIV.

“We know that stem cell transplants are not a viable means of curing most people living with HIV, but each new case of a cure provides clues for developing more scalable interventions as well as avenues for further research,” said Andrea Gramatica, PhD, vice president and director of research at amfAR. “While we can learn from these cases, amfAR will continue to vigorously pursue a range of strategies aimed at delivering a more practical cure than can be made widely available to people living with HIV.”