HIV cures 3, 4 and 5: Düsseldorf case published, City of Hope patient gives public interview, New York case published

Richard Jefferys, TAG

The news on 20 February 2023 was awash with stories about the Düsseldorf Patient, one of five people considered likely cured of HIV after receipt of a stem cell transplant to treat a life-threatening cancer diagnosis.

As with all five reported cases to date, the stem cell donor was homozygous for the CCR5 delta-32 mutation, which renders immune cells resistant to most HIV variants. The media coverage has been prompted by the publication of a detailed report in the journal Nature Medicine by Björn-Erik Ole Jensen and colleagues. [1]

The individual, who identified himself as Marc in an interview with a Dutch news outlet in 2021, has now been off antiretroviral therapy (ART) for four years with no sign of HIV viral load rebound. [2]

His current health is reported to be good, although the paper makes clear his journey has been difficult having experienced two relapses of acute myeloid leukemia and reactivation of multiple chronic viral infections (cytomegalovirus, herpes simplex virus 2, human herpesvirus 8 and Epstein–Barr virus). Mild chronic graft-versus-host disease of the eyes with bilateral keratoconjunctivitis sicca (dry eye syndrome) developed after the stem cell transplant and is still present.

The news headlines are potentially confusing because some state Marc is the third case [3] to reflect the chronological sequence (after Timothy Ray Brown and Adam Castillejo) while others designate him the fifth [4] to reflect the total number of cases described to date, which include two more recent examples in New York City [5] and at the City of Hope in Los Angeles [6].

The first scientific description of the Düsseldorf Patient was in a poster presentation at the 2016 Conference on Retroviruses and Opportunistic Infections (CROI), prior to interruption of ART. Two post-interruption follow up posters were presented at CROI in 2019 and 2020. [7]

The HIV cure research field has thus been aware of the case for a long time, and there was frustration and confusion last year when the announcement of a fifth similar possible HIV cure at the City of Hope mistakenly referred to it as the fourth based on the unnecessarily prim rationale that information on the Düsseldorf Patient hadn’t yet been published in a journal. [8]

Today’s publication will hopefully put any uncertainty to rest.

Source

Jefferies R.  The Düsseldorf Patient HIV Cure Case Published in Nature Medicine. TAG Basic Science Blog. (20 February 2023).
https://tagbasicscienceproject.typepad.com/tags_basic_science_vaccin/2023/02/the-d%C3%BCsseldorf-patient-hiv-cure-case-published-in-nature-medicine.html

References

1. Jensen B-E O et al.  In-depth virological and immunological characterization of HIV-1 cure after CCR5Δ32/Δ32 allogeneic hematopoietic stem cell transplantation. Nat Med 29, 583–587 (2023). DOI: 10.1038/s41591-023-02213-x. (20 February 2023).
   https://www.nature.com/articles/s41591-023-02213-x
2. https://www.nrc.nl/nieuws/2021/12/10/hij-is-de-derde-mens-ter-wereld-die-genas-van-hiv-2-a4068420
3. France 24 news. Third patient cured of HIV after receiving stem cell cancer treatment. (20 February 2023).
   https://www.france24.com/en/europe/20230220-third-patient-cured-of-hiv-after-receiving-stem-cell-cancer-treatment
4. ABC news. 5th person confirmed to be cured of HIV. . (20 February 2023).
   https://abcnews.go.com/Health/5th-person-confirmed-cured-hiv/story?id=97323361
5. https://tagbasicscienceproject.typepad.com/tags_basic_science_vaccin/2022/02/croi-2022-update-a-new-potential-hiv-cure-case-broadly-neutralizing-antibody-enhances-post-treatment.html
6. https://tagbasicscienceproject.typepad.com/tags_basic_science_vaccin/2022/07/aids-2022-another-possible-hiv-cure-case-after-stem-cell-transplantation-for-cancer-example-of-exten.html
7. Kobbe G et al. Treatment of HIV and AML by allogeneic CCR5-d32 blood stem-cell transplantation. CROI 2016, poster abstract 264.
   https://www.croiconference.org/abstract/treatment-hiv-and-aml-allogeneic-ccr5-d32-blood-stem-cell-transplantation
8. City of Hope press release. Patient with HIV achieves remission following stem cell transplant at City of Hope. (27 July 2022).
   https://www.cityofhope.org/hiv-patient-achieves-remission-following-stem-cell-transplant-city-of-hope
9. ABC news. Interview with City of Hope patient. (30 March 2023),
   https://bit.ly/3K3vhOH
10. Hsu J et al. HIV-1 remission and possible cure in a woman after haplo-cord blood transplant. Cell. 2023 Mar 16;186(6):1115-1126.e8. doi: 10.1016/j.cell.2023.02.030.
    https://pubmed.ncbi.nlm.nih.gov/36931242