HIV-positive man with blood cancer undergoes stem cell therapy; Gets cured of both

In an astonishing incident, a 53-year-old man from Germany has made it to the list of a few lucky patients with HIV to be declared clear of the virus.

The man was declared virus-free after receiving a stem cell transplant that also treated his leukaemia. The findings of the study were published in the Nature Journal on Monday.

Previously, two other patients with both HIV and cancer, in Berlin and London, have been reported as cured in scientific journals following the high-risk procedure.

In 2008, the german man was found to be HIV positive in 2008, then three years later he was diagnosed with acute myeloid leukaemia which is a life-threatening form of blood cancer.

According to the study, the man, also known as, Düsseldorf patient, had a bone marrow transplant using stem cells from a female donor with a rare mutation in her CCR5 gene. Scientists claim that the mutation has been found to stop HIV from entering cells.

The study also revealed that the Düsseldorf patient stopped taking antiretroviral therapy (ART) in 2018 and has remained HIV-free since.

However, this isn’t the first case. The stem-cell technique involved was first used to treat Timothy Ray Brown, often referred to as the Berlin patient. After the procedure, the Berlin patient was able to stop taking ART and remained HIV-free until his death in 2020.

“There are 5 case reports till date in the world literature of curing HIV with the help of stem cell transplants. These stem cell transplants were carried out for incurable blood disorders, mainly blood cancers. These stem cells were used from a donor who carries the homozygous CCR5 delta 32 mutation. Now more researches and studies are taking place in this field to cure HIV with such transplants not stem cell therapy,” Dr. Dharma Choudhary, Director and HOD, Blood and Marrow Transplant, Sanar International Hospitals told Financial Express.com.

In 2019, researchers revealed that the same procedure seemed to have cured the London patient, Adam Castillejo. And, in 2022, scientists announced that they thought a New York patient who had remained HIV-free for 14 months might also be cured, although researchers cautioned that it was too early to be certain.

“Though WHO IMPACT P1107 trial of treating HIV patients with cancer has shown some promising results , more research is needed to look at it as a feasible and sustainable treatment modality,” Dr. Siddharth Gautam, Consultant Neurosurgeon, Cooper Hospital & HBT told Financial Express.com.

According to Ravindra Gupta, a microbiologist at the University of Cambridge, UK, who led the team that treated Castillejo, says the latest study “cements the fact that CCR5 is the most tractable target for achieving a cure right now”.

The scientists also found that the Düsseldorf patient had extremely low levels of HIV, thanks to ART, when he was diagnosed with acute myeloid leukaemia.

“Cancer and HIV are both incurable diseases, however in this groundbreaking medical case, the “London patient” was cured of both after undergoing a stem cell transplant. The patient received the transplant from a donor with a rare genetic mutation that made them resistant to HIV. A stem cell transplant is a medical surgery in which the patient’s body is given stem cells to replace unhealthy or damaged cells and tissues. The use of stem cell therapy to cure diseases is still in the early stages of development, and this case provides hope for future breakthroughs,” Dr. Kanury Rao, Co-Founder & CSO, PredOmix told Financial Express.com.

According to Dr. Rao, while the procedure is not without risks, it has the potential to provide new treatment options for patients who may have exhausted all other available therapies. “There is promise for future innovations because of this situation. This instance also demonstrates the ongoing need for HIV and cancer research and development,” Dr. Rao added.

The researchers are planning to study if a person has a larger reservoir of HIV at the time of receiving a transplant then how the immune system recovers and eliminates any remaining viruses from the body.

According to Dr Preetam Jain, Medical Oncologist at Bhatia Hospital Mumbai stem cell therapy is mainly used to treat Hematological malignancy (blood cancers) and few solid malignancies.

“Stem Cell therapy can be curative for Certain Cancers. However, treating Cancer who also is suffering from HIV positive poses a significant challenge to the treatment success,” Dr. Jain told Financial Express.com.

The cure factor with stem cell therapy depends on multiple factors like

1. HIV disease status
2. CD4 Count
3. HIV Viral load
4. Type of Cancer they are suffering from
5. Stage of cancer
6. Presence or absence of Opportunistic infections in HIV

“First important aspect is selection of the patient. Whether the hiv + patient with cancer is eligible for transplant or not. This is especially important in view of Multiple threat of opportunistic infections that these patients are at risk. Also, HIV + with Cancer, may have an aggressive disease and carry overall poor prognosis. Risk of relapse if cancer is high due to immunocompromise status. Stem cell therapy can cure the cancer but not HIV. Even now, HAART is the cornerstone of therapy for controlling the HIV,” Dr. Jain told Financial Express.com.