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For only the second time, a patient with HIV who received an allogeneic hematopoietic stem cell transplant from a donor with an HIV resistance gene appears to have been cured of the disease, according to a recent study.
Known in medical studies as “the London patient,” 40-year-old Adam Castillejo underwent the transplant for Hodgkin lymphoma. In 2011, the first such case was reported in Berlin. That patient, Timothy Ray Brown, underwent total body irradiation and 2 stem cell transplants from a donor with an abnormal CCR5 gene, which confers resistance to HIV. Brown also underwent chemotherapy to kill any residual virus. Castillejo underwent similar treatment, with 1 stem cell transplant from a donor having the CCR5 defect and chemotherapy but not total body irradiation.
“Our findings show that the success of stem cell transplantation as a cure for HIV, first reported nine years ago in the Berlin patient, can be replicated,” the study’s lead author, Ravindra Kumar Gupta, BMBCh, PhD, of the University of Cambridge in the United Kingdom, said in a statement.
The study suggests that a less intensive treatment approach than Brown received also might cure the infection. After 30 months in remission, 99% of Castillejo’s immune cells were from the donor, and he had no signs of active viral replication in samples from multiple tissues.
“It is important to note that this curative treatment is high-risk, and only used as a last resort for patients with HIV who also have life-threatening hematological malignancies,” Gupta cautioned.
Kuehn BM. Study Suggests a Second Patient Has Been Cured of HIV. JAMA. 2020;323(19):1886. doi:10.1001/jama.2020.7626
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