Stem Cell Transplant Cures Oldest HIV Patient

HIV virus

California-based biomedical research institution City of Hope revealed Wednesday that the oldest person living with HIV has achieved clinical remission after undergoing stem cell transplantation at the center more than three years ago. The 66-year-old man, who had lived with HIV for more than 31 years, is the fourth patient to be cured through stem cell therapy.

The patient received the stem cell transplant in early 2019 after he developed acute myelogenous leukemia, a common comorbidity in older people living with HIV. He is also in remission from the blood cancer.

“When I was diagnosed with HIV in 1988, like many others, I thought it was a death sentence,” the City of Hope patient, who wishes not to be identified, said. “I never thought I would live to see the day that I no longer have HIV. City of Hope made that possible, and I am beyond grateful.”

According to City of Hope experts, the patient achieved HIV remission because the stem cell donor harbored the CCR5 delta 32 mutation, a rare but beneficial genetic mutation, that makes those who have it resistant to most HIV strains. The HIV virus enters immune cells through the CCR5 receptor, but this mutation disables that pathway and stops the virus from establishing itself in the body.

Since recovering from the procedure, the patient has not shown signs of HIV replication in blood and tissue samples. In March 2021, more than a year after the transplantation, the patient stopped taking antiretroviral therapy (ART), which he had been on for over three decades. He remains in remission as of writing.

“We are proud to have played a part in helping the City of Hope patient reach remission for both HIV and leukemia. It is humbling to know that our pioneering science in bone marrow and stem cell transplants, along with our pursuit of the best precision medicine in cancer, has helped transform this patient’s life,” Robert Stone, president and CEO of City of Hope, said in a statement. 

The first antiretroviral drug ever to be given approval by the U.S. Food and Drug Administration was azidothymidine, which won the nod in 1987. Since then, the industry has developed an ever-expanding roster of antiretroviral medicines, and the field of HIV therapeutics has grown greatly. Cutting-edge technologies in biomedicine have energized the search for a cure.

Following its knockout success with developing mRNA vaccines against COVID-19, Moderna has decided to direct this technology to HIV. Last March, the industry giant announced that it had dosed its first participant with mRNA-1574, a trimer shot meant to prevent the infection from happening in the first place. This approach is in contrast with ART, which only suppresses the virus after it has already lodged itself in the body. The vaccine candidate is currently in a Phase I study designed to assess its safety and immunogenicity.

While prevention is ideal, there is still strong demand for functional cures. Hong Kong-based Ascletis is trying its luck in this arena with its ASC22 (envafolimab) candidate, which is currently undergoing Phase II evaluations as a combination treatment with ART. Gilead Sciences is also working on a solution for patients with multi-drug-resistant HIV. Its candidate, lenacapavir, is designed to be a long-acting inhibitor against the infection. Last month, the company resubmitted its New Drug Application for its candidate. 

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