A Norwegian man who lived with HIV for more than a decade has become the 10th person in the world to be in long-term remission from the virus, according to a new study.
The 63-year-old man, known as the ‘Oslo Patient’, was diagnosed with HIV in 2006 and started antiretroviral therapy in 2010, eventually reaching an ‘undetectable’ status. In other words, the virus was not transmitted sexually, but remained in the body.
In 2017, he developed fatigue and a sharp drop in his blood cell count, and the following year he was diagnosed with myelodysplastic syndrome, a type of bone marrow cancer. After initially responding to treatment, the disease relapsed, prompting doctors to perform a bone marrow transplant to replace the diseased cells.
His brother served as a donor, and doctors discovered that his stem cells had a rare genetic mutation that made them resistant to HIV, according to a study published April 13 in the same journal. natural microbiology.
This mutation, known as CCR5-delta 32, disables a protein on immune cells that HIV uses to invade and infect immune cells. Because the brothers had two copies of the mutation, the virus was effectively locked out of their cells.
After identifying the mutation, the treatment team at Oslo University Hospital closely monitored the transplant to see if it would “cure” the patient of HIV, or put the virus into remission.
The researchers spent five years discovering that the donor’s HIV-resistant cells replace the patient’s immune system, eliminating the receptors that HIV uses to enter white blood cells and preventing the virus from infecting and replicating new cells.
Researchers also observed that his immune system’s T cells no longer behaved as if they were being attacked by HIV.
Analysis of blood, intestine and bone marrow samples showed that “complete donor chimerism” had been achieved, according to the study. This means that almost 100% of his hematopoietic and immune cells are derived from HIV-resistant stem cells. This milestone showed that the transplant had successfully replaced his diseased cells.
The patient discontinued antiretroviral therapy after 2 years, and no intact HIV DNA was detected in the blood or intestines 4 years after transplantation. The researchers also found that there was no virus capable of replicating, that there was no immune response targeting HIV, and that HIV-specific antibodies decreased over time.
After five years of follow-up, doctors found no trace of “working” HIV DNA in his body.
Study author Marius Trosaid said: live science Patients feel like they’ve won the lottery twice.
“He has been cured of a potentially fatal bone marrow disease and is probably cured of HIV now,” Trosade said.
The transplant appears to have been successful, but doctors are hesitant to call it a complete “cure” because the procedure is not feasible on a large scale.
According to , as of 2024, approximately 41 million people worldwide will be living with HIV. world health organization.
Bone marrow stem cell transplants are considered a “dangerous immune system reboot” that can lead to serious infections and are usually only done as a last resort. science alert. Previous studies suggest that 10% to 20% of patients die within 1 year after surgery.
In fact, the Oslo patient also experienced a serious complication known as “graft-versus-host disease,” in which the body attacks the transplanted cells as foreign substances. He was treated with immunomodulatory drugs and recovered. Over time, HIV-resistant cells took hold, effectively rebuilding his immune system and putting the virus into remission.
Despite the risks and difficulties of replicating this procedure on a large scale, the researchers say their findings could help develop more accessible treatments that could one day cure HIV.
Source: Metro Weekly – www.metroweekly.com
