Madrid. A transplant of stem cells with a certain mutation, in this case coming from a brother, has achieved the cure of a man with HIVwhich brings to 10 the number of people in remission from that disease since the ‘Berlin patient’ in 2009.
The case of the person now known as ‘patient of Oslo‘has been published in Nature Microbiologyin a study led by the Oslo University Hospital and with the participation of the IrsiCaixa AIDS Research Institute of Barcelona.
Moving on from the ‘patient’ case Berlin‘ to a dozen people in remission from HIV allows us to have more extensive data on the healing process and promote new eradication strategies, the researcher tells EFE Maria Salgado of IrsiCaixa and one of the signatories of the study.
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The ‘Oslo patient’ is a 63-year-old man who was diagnosed with HIV at age 44. In 2020 he received a stem cell transplant to treat a myelodysplastic syndromea type of blood cancer, and a donor was sought with the genetic mutation natural CCR5-delta 32.
Two years later, by indication and with medical follow-up, he left the antiretroviral treatment for HIV and four years after that withdrawal there is still no detectable trace of the virus.
A stem cell transplant is a “very aggressive” procedure indicated in blood cancers and not applicable to the general population with HIV, who with current treatments “have a life expectancy that is very little different from that of a person without HIV and a fairly good quality of life,” explains Salgado.
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However, “these milestones allow us to better understand how healing occurs and move toward strategies more applicable to all people with HIV,” according to Javier Martínez-Picadoof IrsiCaixa and also a signatory of the article.
“That today there are 10 patients in remission is not a coincidence, it is the result of more than a decade of international research“, states the scientist in a statement from IrsiCaixa.
Martínez-Picado is the coordinator of the international consortium IciStem 2.0 dedicated to the study of curing HIV through stem cell transplants, which is the one that has documented the most cases in the world, four so far.
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In cases like that of the ‘Oslo patient’, which have a hematological cancerdonors are sought who carry the CCR5-delta 32 mutationwhich prevents the virus from entering HIV target cells, CD4 T lymphocytesand infect them.
In this case, no compatible donor was found in the records and the brother, who unexpectedly was a carrier of the disease, was chosen for the first time. mutation.
At 63 years old, he is, along with a patient from the United States, one of the oldest to have undergone this treatment, “which opens the possibility that the cure is not limited to certain ages or certain health status”Salgado highlights.
Looking at the cures so far, the protective role of the CCR5-delta32 mutation is confirmed. When the donor had two mutated copies of this generemission of HIV was achieved, while in several cases with a single copy or none, the virus reappeared after removing the medication.
But there are exceptions: a second patient in Berlin and another in Genevawho were cured although their donors did not have the double mutation.
Salgado points out that, in these cases, the calls natural killer cells (a type of lymphocytes) “were quite powerful and seemed to have helped eliminate the hidden virus.”
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With 10 patients already cured, Salgado says that the researchers you can start to see patterns in common and start looking for other techniques and therapies that mimic these types of strategies.
Among them, IrsiCaixa has begun to investigate with the cellular therapy CAR-T, which is already used with good results in some blood cancers. This would involve modifying the patient’s own immune cells so that they recognize and destroy the target cells of HIV.
Other teams are also preliminarily investigating gene therapies to modify the CCR5 gene and induce the famous CCR5-delta32 mutation, thus blocking the entry of the virus in the cells.
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