"Geneva patient" AIDS or cured virus | infected | patient
According to Agence France Presse on July 19, a man known as "Geneva patient" was in long-term remission of HIV infection after receiving bone marrow transplantation without known gene mutation of blockable virus, which may open up some avenues for research.
Before him, five people who had received bone marrow transplants were believed to have been cured of HIV infection. The cured patients all have a common special situation. They suffer from blood cancer and benefit from stem cell transplantation, which deeply updates their immune system.
But their donors all have a rare CCR5 delta 32 gene mutation, which is known to prevent HIV from entering cells.
For this Geneva patient, the situation is different: he received a stem cell transplant in 2018 to treat a particularly aggressive leukemia. But this transplant came from a donor who did not carry the aforementioned gene mutations. Therefore, unlike the cells of other people who are considered to be cured, donor cells can theoretically make HIV reproduce.
However, the virus has not been detected since the University Hospital of Geneva, together with the Pasteur Institute, the Keshang Institute and the International Cooperation Project on Stem Cell Transplantation and Treatment of AIDS, interrupted the antiretroviral treatment of the patient for 20 months. "We believe that when the virus cannot be detected for more than 12 months, the likelihood of not being detected in the future will significantly increase," said Asier Seth Sirion, head of the virus bank and immune control department at the Pasteur Institute
How to explain this patient's phenomenon? There are several hypotheses in front of us.
Seth Sirion pointed out, "In this specific case, perhaps transplantation eliminated all infected cells without the need for rare mutations. Alternatively, immunosuppressive therapy required after transplantation played a role."
Sharon Lewin, president of the International Association for AIDS, warned that the long-term relief was "encouraging", but "only one virus particle can cause the virus to rebound".
He also stated that the patient "will need to be closely monitored in the coming months or even years. The possibility of a rebound is unpredictable.".
Although these alleviations bring hope for the final victory over HIV, bone marrow transplantation is still a very heavy and dangerous operation, and it is not suitable for most HIV carriers.
However, these cases have opened up some new avenues for research, such as the potential role of immunosuppressive therapy.
Sais Sirion also stated, "This also prompts us to continue studying certain innate immune cells that may affect the control of the virus."
Seth Sirion talks to Francoise Barr Sirion, who won the Nobel Prize with two other people in 2008 for the discovery of AIDS.
