The man underwent a bone marrow stem cell transplant with a rare mutation that prevents HIV from multiplying
Confirmed. The ‘Düsseldorf patient’, a 53-year-old man whose identity remains anonymous, has finally been recognized as the third patient in the world to be cured of his AIDS infection thanks to a marrow stem cell transplant I mean. The man has now been free of both HIV and the antiretroviral treatment that he once needed to keep it under control for four years. After the advance, which is published today in the journal ‘Nature’, there is an international consortium called IciStem, which is co-led by a Spanish researcher from the IrsiCaixa network, Javier Martínez Picado. He is the same man who has already achieved that more than thirty Spanish patients live without anti-AIDS medication. The names of all of them do not appear, however, on the ‘official’ list of ‘cured’ because there are still traces of the virus that caused the last pandemic of the 20th century in their blood. Still, the list of victors from AIDS, albeit slowly, is growing.
«I was diagnosed with HIV in 2008. I still remember my family doctor’s phrase very well: ‘Don’t take it the wrong way’. We will experience together that HIV can be cured! His promise has come true.” With these words he explains today in Nature his victory against the Human Immunodeficiency Virus (HIV), the third patient who manages to defeat it thanks to a bone marrow transplant. His name has not been revealed, but his testimony is included in the article that describes the new step taken in the fight against AIDS. «On Valentine’s Day (last February 14) I celebrated the tenth anniversary of my bone marrow transplant in a big way. My donor was present as a guest of honor,” he says with satisfaction. “Today I am even more proud of my global team of doctors, who managed to cure me of HIV and, at the same time, of course, of leukemia.”
exceptional cases
His story is the same, or very similar, to that of Timothy Brown, known as ‘the Berlin patient’ and Adam Castillejo, ‘the London patient’, who were the first to overcome HIV infection with this same therapy. . In all three cases, undergoing a bone marrow stem cell transplant allowed them to overcome the leukemia they suffered from and, at the same time, eradicate the AIDS virus from their body. All three are exceptional cases, very difficult to replicate in the group of affected patients, almost 38.5 million in the world.
As with Brown and Castillejo, the donor chosen for the intervention fulfilled two qualities. One, that his marrow was logically compatible with what the Düsseldorf patient needed; and another, which also had a mutation called CCR5Delta 32, which prevents the replication of the AIDS virus. Only one in a hundred people carry this mutation; and then you have to find someone whose marrow is compatible with that of the patient in question. The possibilities of something like this happening, as he has commented on more than one occasion. “It’s almost like finding a needle in a haystack,” said the director of the AIDS Immunopathology Unit of the Carlos III Health Institute, José Alcamí, who also expressed the “merit” of the work carried out.
Cured with cord cells
The patient from ‘Düsseldorf’ is in the news like this again, almost three years after his story was known, published when Castillejo’s cure was confirmed, in March 2020. On that date, the third cured had been ‘only’ fourteen months without viruses in the absence of medication, a time still too early to consider their situation as good, which science has now recognized.
Just one year ago now, on February 17, 2022, the cure of an HIV-positive woman was also known, who was the first in the world to overcome HIV infection with an umbilical cord cell transplant. The same result, the cure, with a different procedure. The fact that they were stem cells from the cord, also with the CCR5 gene mutation, was highly relevant, according to Alcamí. Those extracted from the bone marrow guarantee compatibility for one in six million people. With those of cord, that possibility rises to 50%. Why not resort to them? Because, “in addition to other ethical considerations”, this type of intervention carries a mortality rate of 30%.
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