A 60-year-old man in Germany has become the seventh known person to achieve prolonged HIV remission after receiving a stem cell transplant. The finding rekindles hope for broader treatments, given that the donor did not carry the usual complete protective mutation.

What makes this transplant special, and why it matters

The new case was presented at the AIDS 2024 conference in Munich and confirmed by researchers as a remarkable finding. The patient—diagnosed with HIV in 2009 and with acute myeloid leukemia in 2015—received a transplant that same year. His donor carried only one copy of the CCR5 Δ32 mutation, unlike previous cases with two copies.

Until now, cases of HIV “cure” after transplant had relied on donors with both copies of the CCR5 Δ32 mutation, which makes their cells resistant to the virus. This new result suggests that even a heterozygous donor may be sufficient to achieve sustained remission, drastically expanding the potential donor pool.

After the transplant, the patient stopped antiretroviral medication in 2018. Six years later, no trace of HIV can be detected in his blood or in intestinal tissue biopsies, indicating sustained remission.

This case, dubbed “the next Berlin patient,” does not immediately change treatment options for most people living with HIV—the transplant remains dangerous, costly, and reserved for those who require it due to cancer—but it does represent a key proof of concept: a cure could be more accessible if replicated with heterozygous donors.

Limitations and caution: why this is not yet a generalizable cure

Despite the success, experts warn that this type of transplant cannot be applied as a general HIV treatment. The procedure involves intensive chemotherapy, risks of rejection, complications, and even mortality, so it is only justified in patients with severe hematological diseases.

Moreover, the exact mechanism of viral eradication is not fully understood. It remains unclear why a donor with only one copy of CCR5 Δ32 achieved such lasting results. Hypotheses include: the complete replacement of the immune system, the elimination of residual infected cells, and a possible immune action from the graft.

For this reason, although the case broadens the horizon, researchers agree that it cannot yet be considered a universal cure. Other less invasive strategies—such as gene therapies or immunotherapies—are still necessary for most people living with HIV to benefit without extreme risks.

What this breakthrough represents for the future of HIV therapies

The success of the seventh case renews hope for a lasting HIV cure, beyond the continued use of antiretroviral drugs. It expands the possibility of having more suitable donors, since many more carry only one copy of the CCR5 Δ32 mutation.

Researchers can now focus efforts on less aggressive techniques: gene editing, immunotherapies, or cell therapies that mimic the effect of the transplant without the need for chemotherapy or risk of rejection.

In addition, this case demonstrates that prolonged remission is possible without completely eliminating the CCR5 receptor—suggesting that other immunological factors may be key. This opening could accelerate the development of treatments accessible on a global scale.

For now, this milestone brings hope to millions of people living with HIV: it shows that, although rare, a real cure is possible.

The seventh successful case of HIV remission after stem cell transplant broadens the therapeutic horizon. Although not an option for everyone, it demonstrates that long-term viral elimination is possible and paves the way toward safer, more accessible treatments, bringing closer a future with a reduced HIV burden worldwide.

Reference:

• Nature/Sustained HIV-1 remission after heterozygous CCR5Δ32 stem cell transplantation. Link
• Nature/CD8+ T cell stemness precedes post-intervention control of HIV viremia. Link
• Nature/Correlates of HIV-1 control after combination immunotherapy. Link

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