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HIV Remission Achieved with Single-Copy Gene Mutation
1 Dec
Summary
- A German patient has been in HIV remission for six years.
- Stem cell transplant used donor cells with one resistance gene copy.
- This suggests alternative paths to potentially curing HIV.
A German patient, referred to as Berlin 2 (B2), has maintained an HIV-free remission for an impressive six years after undergoing a stem cell transplant to treat leukemia. This marks him as the seventh individual known to achieve such long-term remission. Unlike previous cases where stem cell donors possessed two copies of the CCR5 Δ32 mutation conferring HIV resistance, B2 received cells with only a single copy. This finding challenges established theories on the mechanisms of HIV clearance and opens new avenues for research.
HIV's resilience stems from its ability to attack immune cells, mutate rapidly, and hide within dormant reservoirs. Antiretroviral therapy can suppress the virus, but latent reservoirs remain untouched. Stem cell transplants, by eradicating the patient's existing immune system and rebuilding it with donor cells, have proven effective in depleting these reservoirs. The graft-versus-reservoir response is crucial, where new immune cells target and eliminate remaining HIV hideouts.
While the CCR5 Δ32 stem cell procedure is not poised to become a standard HIV treatment due to its intensity and risks, the success in B2's case and other similar instances is invaluable. It shifts the focus from rare genetic mutations to understanding how to replicate reservoir reduction and graft-versus-reservoir responses through potentially less invasive means like pharmaceutical treatments and gene editing.
