Third person 'cured' of HIV after receiving stem cell cancer treatment

A 53-year-old man in Düsseldorf, Germany, has been declared cured of HIV by doctors after a blood stem cell transplant to treat leukaemia – the third case of this kind.

The man has no signs of active infection four years after he stopped taking antiretroviral drugs. “We don’t think there’s a functional virus present,” says Björn Jensen at Düsseldorf University Hospital.

The “Düsseldorf patient” tested positive for HIV in 2008. In 2011, he developed leukaemia that was treated with chemotherapy, but it came back the following year. So, in 2013, the blood stem cells in the man’s bone marrow that give rise to immune cells – including the cancerous ones – were killed off by chemotherapy and then replaced with donor blood stem cells.

Crucially, doctors found a donor with a mutation that disables the CCR5 receptor that HIV uses to infect immune cells. This transplant made the man’s immune system HIV-resistant.

In 2017, the team was able to stop giving him immunosuppressing drugs to prevent rejection of the donor cells and, in November 2018, antiretroviral treatment was halted.

Two other people treated for cancer have previously been reported to have been cured of HIV in the same way. However, because bone marrow transplantation is risky, and given that drug treatment can keep the virus in check, this will never be used to treat HIV alone.

One alternative approach that is being explored is to use gene editing to mutate the CCR5 gene in the immune system of people who are HIV-positive.

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