Durban - An international group of physicians and researchers have identified another case in which HIV infection has been cured.
A 53-year-old man from Germany is now the third person in the world to be completely cured of HIV by a stem cell transplant.
The researchers included Dr Annemarie Wensing, an honorary of Ezintsha, a division of the Wits Health Consortium, and Dr Monique Nijhuis, from the HIV Pathogenesis Research Unit at Wits University.
In a study published in Nature Medicine, the successful healing process of this third patient was for the first time characterised in great detail virologically and immunologically over a 10-year duration.
The patient was cured using Haematopoietic stem cell transplantation for the treatment of severe blood cancers, and this was the only medical intervention that previously cured two people living with HIV.
“Haematopoietic” refers to an immature cell that can develop into all types of blood cells, including white blood cells, red blood cells, and platelets. Hematopoietic stem cells are found in the peripheral blood and the bone marrow, and are also called blood stem cells.
According to the University of the Witwatersrand, the patient, treated at the University Hospital Düsseldorf for his HIV infection, had received a stem cell transplant due to blood cancer (leukaemia).
As in the cases of the first two patients, named “Berlin” and “London” respectively, the Düsseldorf patient received stem cells from a healthy donor whose genome contains a mutation in the gene for the HIV-1 co-receptor CCR5.
“This mutation makes it nearly impossible for most HI viruses to enter human CD4+ T-lymphocytes, their major target cells that cause HIV infection in humans. Following transplantation, the Düsseldorf patient was carefully monitored virologically and immunologically for almost 10 years,” the university said.
It further said a variety of sensitive techniques were used. In particular, the researchers analysed the patient’s blood and tissue samples to closely monitor immune responses to HIV and the continued presence or even replication of the virus.
“More than four years ago, the patient’s antiviral therapy against HIV was discontinued. Ten years after transplantation and four years after the end of anti-HIV therapy, the Düsseldorf patient could be declared cured by the international research consortium,” read the statement.
The clinical virologist, Dr Annemarie Wensing at Wits University, said they could not detect any complete HIV variants in tissues or blood.
“HIV immunity also faded away, which shows that the immune system is forgetting about the HIV infection that was once there. This cure means that we do gain insight into the dynamics of the immune systems and the viral reservoirs during the cure. The implications are that switching off the CCR5 receptor is a key step in these cures. However, the limitations are that stem cell transplantations cannot be performed on a large scale, so other ways to modify the receptor need to be studied,” said Wensing.
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