A patient in Germany received a bone marrow transplant carrying a gene that fights the AIDS virus. This discovery proves that HIV can be cured and gives researchers leads for treatments.
This is a case that comes forty years after the discovery of the virus responsible for AIDS, in 1983, and it was the subject of a publication in NatureMedicine, Monday, February 20. And it’s the third case of probable cure of HIV after a bone marrow transplant, according to the count of the Pasteur Institute which participates in this discovery alongside the University Hospital of Düsseldorf, the universities of Hamburg, Utrecht and IrsiCaixa AIDS Research Institute..
This healing took place in Germany. This patient from Düsseldorf had leukemia in addition to his HIV, he was resistant to all treatments. To treat him, his doctors looked for a very special and extremely rare bone marrow donor: someone carrying a genetic mutation that naturally prevents the virus from entering cells, the CCR5 delta-32 genetic mutation. This transplant was a real success against leukemia and against the AIDS virus. Four years after this bone marrow transplant, this individual no longer has any trace of the virus in his body.
A very risky transplant
This is the third case of HIV cure after a transplant of this type, two other patients treated in the same way, two Americans, have also been cured. Their case will soon be the subject of a scientific publication. But we will not be able to do this transplant to all the sick to cure them. This bone marrow transplant with the “anti HIV” genetic mutation is far too risky, the mortality rate is high and the side effects are very heavy. A researcher from the Institut Pasteur, member of the international consortium who made this discovery, explains that this treatment is reserved for people for whom there are no other solutions.
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“It is necessary to find an immunogenically compatible donor to avoid rejection of the transplant, explains Asier Sáez-Cirión, head of the Viral Reservoirs and Immune Control Unit at the Institut Pasteur, and co-lead author of the study. Additionally, since less than 1% of the general population carries this protective HIV mutation, it is very rare for a matched marrow donor to have this mutation. In the end, it is an exceptional situation when all these factors coincide for this transplant to be a double success in curing leukemia and HIV.”
But this third case of cure shows the way to defeating HIV: first you have to empty the body of this reservoir of infected cells, which bone marrow transplantation allows, then strengthen the body’s barriers, which carries out the famous genetic mutation of the donor.
Gene therapy would make it possible to cure HIV and not just continue to live with it. The idea is to modify molecules in the body to mimic this genetic mutation which naturally protects against HIV. There are several techniques studied: either we take the cells out of the organism, we do this work in the laboratory and we reinject them, or we do a simple injection with something inside that cuts the genes directly in the organism. . In both cases, the patient would recover without undergoing an operation and without having to take lifelong treatment.