- Two more patients were announced functionally “cured” of HIV during AIDS 2022.
- One male patient underwent a bone marrow transplant from a donor who is HIV immune.
- The other person, a woman, has an “atypical” number of special cells that may attack HIV, making her an “elite controller” of the infection.
Two more HIV-positive patients have been “cured” of the human immunodeficiency virus, scientists announced at AIDS 2022 this week in Montreal.
One person is a cancer patient, and the other is a woman who seems to have a mysterious and special innate ability to control the virus, post-treatment.
The finds — while both still very rare — are two distinct glimmers of hope for HIV/AIDS researchers hunting for a cure for the disease, achieved by two very different mechanisms. Scientists prefer to say these people are in “long term remission,” since we can’t say for certain that the cures are permanent. However, both new cases have had little (if any) evidence of HIV replication in their bodies for several years, a good sign that this isn’t a temporary fix.
Several other cases like these two patients have been noticed around the world in recent years, and the pace of these two distinct brands of “cures” is quickening.
‘Cure’ #1: A special kind of cancer treatment
The first patient who has been deemed functionally cured of HIV is an anonymous man who is being referred to as the “City of Hope” patient (named for the cancer center in California where he was treated for leukemia).
The City of Hope patient’s reported “cure” is a result of a kind of one-two punch for cancer and HIV: using a bone marrow transplantation with HIV-resistant cells. The patient, who is now 66 years old, had been living with HIV for 31 years when he underwent transplantation for leukemia at the age of 63.
His doctor, Jana Dickter, said he has “no evidence of HIV replication” in his body during a presentation Monday at the AIDS 2022 conference in Montreal.
“The purpose of this transplant was to cure his lukemia,” she said, but the same strategy could work for others who are diagnosed with both lukemia and HIV in the future.
There are at least two other men who’ve been effectively “cured” of HIV through similar bone marrow transplants — the Berlin Patient (in 2007), and the London Patient (announced in 2019). In February, a woman in New York became the first female lukemia patient deemed “likely” cured of HIV, using a novel umbilical cord blood transplant, also for blood cancer.
In all of these publicized cases, the patients were treated for cancer with HIV-resistant blood cell transplants sourced from donors with special virus-busting mutations. There is also another man from Dusseldorf, Germany who appears to have been cured in a similar way, but his doctors have been more cautious about publicizing his case in medical literature.
Dickter said that while the City of Hope patient’s treatment isn’t going to be a widespread cure-all for everybody living with HIV around the world, “we’re seeing more blood cancers” in aging HIV-positive patients in the US now, and this strategy could help some of them out.
‘Cure’ #2: ‘Elite’ control of the disease, naturally
The other HIV “cure” announced at AIDS 2022 was a woman in Spain who has been essentially HIV-free for 15 years, after ending treatment with common HIV antiretroviral drugs. (Normally, when patients go off their HIV drugs, they rebound.)
It’s believed she’s part of an unusual group of people around the globe called “elite controllers” whose bodies naturally attack and suppress HIV, even eradicating it completely in some cases without drugs.
Dr. Nuria Climent Vidal from Barcelona said that the anonymous patient’s total HIV-1 DNA was reduced by 98%.
“Maybe she has special genetic factors,” Vidal said Sunday at the conference, adding that the patient has an “atypical” number of special natural killer cells that may attack HIV.
Though it’s unknown exactly how many of these elite controllers exist worldwide, at least two additional cases of what are thought to be natural HIV control have surfaced in recent years.
Californian Loreen Willenberg, another so-called “elite controller” who contracted HIV in 1992 has no trace of the virus in her body. Another woman, diagnosed with HIV in 2013 in Argentina, had a similar case of natural control. Her daughter, born in 2020, is HIV-free, a feat that is usually only accomplished through antiretroviral therapy (ART) HIV drug treatments during pregnancy.
The “elite controller” findings — whether achieved with drugs or without — are, arguably, more exciting for the tens of millions of people living with HIV around the world who don’t have blood cancer. still a bit mysterious, is “potentially translatable to other people,” Dr. Bruce Walker, an HIV researcher at the Ragon Institute in Massachusetts, said in 2020.