A 66-year-old man who was previously diagnosed in 1988 has been in remission of the virus for more than 17 months after ending antiretroviral therapy (ART) following a stem cell transplant from an unrelated donor for leukemia, according to a report from City of Hope, one of the largest cancer research and treatment organizations in the United States.
The City of Hope patient from Southern California had HIV for almost 31 years, the longest period of time among the three other HIV patients who had both leukemia and HIV remission in the past. He had a transplant when he was 63 years old. He also had HIV for the longest period of time among those patients, starting in 1988, before entering remission for both HIV and leukemia.
Before his transplant, the patient underwent a chemotherapy-based, low-intensity transplant regimen established by the City of Hope and other transplant facilities for the treatment of elderly patients with blood malignancies. Older individuals can tolerate the transplant surgery more stronger due to reduced-intensity chemotherapy, which also lowers the risk of transplant-related problems.
Back in 2019, the patient at City of Hope underwent a blood stem cell transplant for acute myelogenous leukemia from an unrelated donor who had a unique genetic mutation. Because of the mutation, those who have it are immune to contracting HIV. HIV employs the CCR5 receptor on CD4+ immune cells to enter and destroy the immune system. However, the CCR5 mutation disables that mechanism, preventing HIV from spreading.
Since the transplant, the patient at the City of Hope has not displayed any indications that the HIV virus is actively multiplying. In March 2021, he discontinued his HIV ART treatment. He could have been able to discontinue the treatments sooner, but he preferred to hold off until he received a COVID-19 vaccination.
News Source: City of Hope
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