Patient got free of HIV after stem cell transplant
A 42-year-old HIV patient with leukemia appears to have no detectable HIV in his blood and no symptoms after a stem cell transplant from a donor carrying a gene mutation that confers natural resistance to the virus that causes AIDS, according to a report published Wednesday in the New England Journal of Medicine.
The patient underwent a stem cell transplant and since, has not tested for HIV in his blood.
“The patient is fine,” said Dr. Gero Hutter of Charite Universitatsmedizin Berlin in Germany.
“Today, two years after his transplantation, he is still without any signs of HIV disease and without antiretroviral medication.”
This case was first reported in November and it was handles by Hutter and a team of medical professionals who performed the stem cell transplant on the patient, an American living in Germany, to treat the man’s leukemia not the HIV itself. The team deliberately chose a compatible donor who has a naturally occurring gene mutation that confers resistance to HIV. The mutation cripples a receptor known as CCR5, which is normally found on the surface of T cells, the type of immune system cells attacked by HIV.
The mutation is known as CCR5 delta32 and is found in 1 percent to 3 percent of white populations of European descent. HIV uses the CCR5 as a co-receptor (in addition to CD4 receptors) to latch on to and ultimately destroy immune system cells. Since the virus can’t gain a foothold on cells that lack CCR5, people who have the mutation have natural protection. (There are other, less common HIV strains that use different co-receptors.)
People who inherit one copy of CCR5 delta32 take longer to get sick or develop AIDS if infected with HIV. People with two copies (one from each parent) may not become infected at all. The stem cell donor had two copies.
Less invasive options to alter CCR5 could be on the horizon within the next five years, said Levy. “It’s definitely the wave of the future,” he said. “As we continue to follow this one patient, we will learn a lot.”
One drug that’s currently on the market that blocks CCR5 is called maraviroc (Selzentry). It was first approved in 2007 and is used in combination with other antiretroviral drugs. In 2007, an estimated 2 million people died from AIDS, and 2.7 million people contracted HIV. More than 15 million women are infected worldwide. HIV/AIDS can be transmitted through sexual intercourse, sharing needles, pregnancy, breast-feeding, and/or blood transfusions with an infected person.
Stem cells from bone marrow, which are also found in circulating blood, have the ability to form blood cells including the white blood cells that fight infection. These are the cells that are attacked by the virus, crippling patients’ immune systems.
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