HIV: A patient cured after a transplant

HIV-positive since 2006 and diagnosed with myelodysplastic syndrome in 2017, a Norwegian patient saw his HIV disappear after a bone marrow transplant in 2020. His brother, the donor, unknowingly carried a rare genetic mutation (CCR5) that makes immune cells resistant to the virus.

This "Oslo patient," described in Nature Microbiology, joins the small group of people considered cured of HIV after a transplant intended to treat blood cancer. These procedures, reserved for serious cases, remain very risky, but the CCR5 mutation significantly reduces the dangers and can eliminate the virus in patients who are also infected.

Doctors had initially searched for a donor carrying this mutation, without success, before turning to the patient's brother. On the day of the transplant, they discovered that he possessed this very mutation, present in only 1% of the local population. The patient described this coincidence as "winning the lottery twice."

Two years after the operation, he was able to stop his antiretroviral treatment: no trace of HIV was detected in his blood, intestinal tissue, or bone marrow. Now 63 years old, he is in excellent health.

These cases remain exceptional and do not constitute a therapeutic avenue for the majority of people living with HIV. However, they offer researchers valuable insights into better understanding the virus.

  Frank Verain

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