Two HIV Patients Show No Signs of Disease Following Bone Marrow Transplants for Hodgkin Lymphoma
Timothy Henrich, MD, Associate Physician in the Division of Infectious Disease at Brigham and Women’s Hospital in Boston, reported that two patients with long-standing HIV infections have no detectable levels of the disease in their blood cells, even though they stopped taking their antiretroviral drugs several weeks ago. Both patients underwent allogeneic bone marrow transplants, one about 3 years ago and the other 5 years ago, to treat their Hodgkin lymphoma.
The announcement was made at the International AIDS Society Conference in Kuala Lumpur, Malaysia.
Both men received donor cells susceptible to HIV, which was different from the stem cells given to American patient Timothy Ray Brown, known as the “Berlin patient,” which carried a mutated version of a key protein— CCR5—needed for HIV to infect cells. Mr. Brown was diagnosed with both HIV and leukemia and has been free of both diseases for 6 years. He is believed to be the only adult declared cured of HIV. (A baby born in Mississippi 2½ years ago to an HIV-infected mother and treated with antiretroviral therapy soon after birth is believed to be the only other patient cured of HIV.)
Too Soon to Declare a Cure
Despite the apparent success of the two Boston patients, Dr. Henrich stressed during his presentation that “longer-term follow-up is going to be needed to understand the full impact of stem cell transplantation with susceptible cells on viral persistence and reservoir ablation. It is possible that the virus could come back next week, a few months from now, and it’s even possible it could take 1 to 2 years for this virus to return to these patients,” said Dr. Heinrich.
While the findings of the two Boston patients and Mr. Brown are encouraging, said Dr. Henrich, giving stem cell transplants to the millions of HIV-infected people is not a practical strategy since the treatment carries a high risk of death and is expensive. “However, I think we can learn quite a bit of information from these types of studies and these types of patients. First of all, what we would like to know is how low do we need to go, what level of reduction of your reservoir do you need to do to have a lasting impact? So we’re hoping that our study will help shed light onto this very, very important, yet completely unknown question,” said Dr. Henrich.
Dr. Henrich said that he is also hoping the study will reveal whether it is the CCR5-mutated HIV-resistant cells that are protecting the patients from HIV recurrence or the antiretroviral therapy that is protecting the donor cells from HIV infection.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
