< strong>▎WuXi Contex Content Team Editor

“When I got HIV in 1988, like everyone else back then, I thought It’s a death sentence. I never thought I’d live to this day to find out I’m HIV-free!”

Thanks to the progress of HIV drug development in the past 30 years, HIV-infected people can have a healthy lifespan similar to that of normal people as long as they take the drugs on time every day. It has also become the only option to accompany them. A man who has been living with HIV for more than 31 years has achieved long-term remission without the need to continue taking antiviral drugs after a stem cell transplant, researchers at the City of Hope Medical Center reported today. The 66-year-old patient is the fourth HIV patient in the world to be “cured” by this method, and the oldest HIV and blood cancer patient to be “cured” after a stem cell transplant,’ the press release noted. Additionally, the results of a 15-year functional cure for a 74-year-old HIV female patient were reported today at the AIDS 2022 Annual Meeting Press Conference . These results offer hope for a “cure” of HIV infection.

Image source: 123RF

The male patient was treated in 2019 He was treated with a stem cell transplant when he was diagnosed with acute myeloid leukemia (AML), a type of leukemia more common in older HIV patients. Stem cell transplantation is one of the common treatments for AML, and when treating this patient, the researchers specifically selected a donor with a rare genetic mutation. The mutation he carried in the gene encoding the CCR5 protein stopped the CCR5 protein from being expressed. CCR5 is a receptor on CD4-positive immune cells that the HIV virus uses to enter and multiply in immune cells. This CCR5 mutation blocks the way the HIV virus enters the cell, thereby preventing the HIV virus from replicating. The potential of this strategy to “cure” HIV infection was first demonstrated more than a decade ago. At the 2008 International AIDS Congress, researchers reported on the case of what was then known as the “Berlin Patient”, an HIV patient named Timsy Ray Brown. Infected people who developed AML at age 40 had no HIV found in the blood after receiving a stem cell transplant with a CCR5 mutation, even when they stopped taking antiviral drugs. He is the first HIV-infected person in the world to be “cured” using this strategy.

Photo source: 123RF CCR5-mutated stem cell transplant achieves ‘cure’. Their case shows that the “cure” of AIDS is no longer an isolated case, and it also means that therapies developed based on CCR5 may have the potential to cure HIV infection. However, stem cell transplantation itself is a complex and high-risk treatment modality. It does not apply to ordinary HIV-infected patients, who are given the opportunity to receive stem cell transplants because of blood cancers. The man reported today was 63 years old when he was treated and is therefore at higher risk for complications after a stem cell transplant. City of Hope researchers designed a reduced-intensity pre-transplant chemotherapy regimen that allowed him to achieve a complete remission of AML before transplant, while reducing the chance of post-transplant complications. This patient received stem cell transplantation in 2019. Fortunately, after receiving treatment, not only did AML achieve complete remission, but HIV did not come back. Now he’s been off antiviral drugs for more than 17 months, and researchers haven’t found any signs of HIV replication in him.

▲One of the research leaders , Dr. Jana K. Dickter, a clinical professor at City of Hope (Image source: Reference [2])

This patient’s outcome has profound implications for HIV treatment, said Dr. Jana K. Dickter, a clinical professor at City of Hope and one of the study leaders. “He was the eldest of (four) patients treated with stem cell transplants, had the longest HIV history, and received the lowest intensity of immunosuppressive therapy. The evidence we obtained showed that if By being able to find suitable stem cell donors for HIV patients with blood cancers, we can use less intensive chemotherapy regimens to achieve the goal of dual remission. This provides new opportunities for older patients with both HIV and blood cancers Opportunity.”Because stem cell transplants themselves still carry significant risks, it is not a recommended treatment option for HIV patients who do not have blood cancers. However, industry experts say the results show that Gene editing of cells in patients may be a future strategy for curing HIV infection. Earlier this year, a company called Excision BioTherapeutics had announced the launch of a Phase 1/2 clinical trial to test the potential of EBT-101, an in vivo gene-editing therapy developed based on CRISPR gene-editing technology, as a one-time treatment for HIV patients. Another HIV patient reported at the AIDS 2022 Annual Meeting press conference was diagnosed with HIV at age 59. In 2006, she participated in a clinical trial where she received multiple immunomodulatory therapies alongside antiviral therapy to enhance the ability of immune cells to control the HIV virus. Trial results showed that her immune system had successfully controlled HIV levels for 15 years after stopping antiviral therapy. Although there was still a replicable HIV virus in her cells, her CD8-positive T cells and natural killer cells had a strong inhibitory effect on HIV. This case demonstrates the potential to effectively control HIV replication by enhancing the activity of immune cells in patients, and is expected to provide an innovative therapeutic development strategy. “For HIV patients, it’s a signal of hope.” Johns Hopkins University School of Medicine Professor Eileen Scully of the Washington Post told The Washington Post, “This strategy works, and it has been validated again. It also shows that the scientific community is actively working to address this challenge.< /span>

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References:

[1] OFFICIAL PRESS CONFERENCE Scientific Highlights. Retrieved July 27, 2022, from ht tps://www.aids2022.org/media/press-conference-programme/

[2] HIV patient achieves remission following stem cell transplant at City of Hope. Retrieved July 27, 2022, from https://www.cityofhope.org/hiv-patient-achieves-remission-following-stem-cell-transplant-city-hope

[3 ] Longtime HIV patient is effectively cured after stem cell transplant. Retrieved July 27, 2022, from https://www.washingtonpost.com/science/2022/07/27/hiv-remission-stem-cell-transplant-city-of -hope/

[4] A 5th person is likely cured of HIV, and another is in long-term remission. Retrieved July 27, 2022, from https://www.nbcnews. com/health/health-news/5th-person-likely-cured-hiv-another-long-term-remission-rcna40116[5] A unique case of a functional cure of the HIV virus. Retrieved July 27, 2022, from https://www.clinicbarcelona.org/en/news/a-unique-case-of-a-functional-cure-of-the-hiv-virus< /span>

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