A fourth person, named only as a ‘City of Hope’ patient, has been cured of HIV using a highly dangerous stem cell treatment reserved only for patients also battling leukaemia.
The unnamed 66-year-old man was treated at the City of Hope National Medical Center in Duarte, California, which earned him his nickname. He received a blood stem cell transplant in early 2019 and has since shown no evidence of HIV replication in his body. He is now 17 months off HIV medication.
The transplant is extremely dangerous and requires doctors to find a donor who has a rare genetic mutation that makes them resistant to the virus. Because of this, it is only reserved for HIV patients who also suffer from late-stage cancer.
Researchers are still hopeful that this success could have a wider impact, and could help many other elderly HIV patients who also suffer from blood cancer at the same time.
The ‘City of Hope’ patient, named after the California hospital where he receives treatment, is functionally cured of both HIV and his leukemia after successful stem cell treatment (file photo)
‘When I was diagnosed with HIV in 1988, I thought, like many others, that it was a death sentence’, said the man in a statement from the hospital.
‘I never thought I would live to see the day when I no longer have HIV. City of Hope made that possible, and I am beyond grateful.’
The hospital reports that the 66-year-old patient had suffered from HIV since 1988 – more than 30 years ago.
He has used antiretroviral therapy drugs to manage the condition and prevent it from developing into AIDS.
His AIDS diagnosis was the longest of any of the others who also had their disease cured by the successful transplant.
After receiving reduced-intensity chemotherapy treatments that make the transplant more tolerable, the man received a blood stem cell transplant in early 2019.
The donor, who is also unnamed, is not related to the man, but has a rare genetic mutation called homozygous CCR5 Delta 32.
People who have the mutation have natural resistance to HIV because they have a CCR5 receptor on their immune cells that can block pathways that the virus needs to replicate.
These types of transplants can be fatal because there is a chance that the body’s immune system will reject the implanted cells and start attacking them.
Doctors at City of Hope found success, and within a few years both the man’s cancer and HIV disappeared.
The treatment is incredibly risky because the body can reject the implants, and the patient can die. Because of these concerns, it can only be used on people who are already at risk of death due to a severe case of cancer (file photo)
Official figures estimate that about 1.2 million Americans suffer from HIV, but one-in-eight cases are still undiagnosed (file photo)
“We were happy to let him know that his HIV is in remission and that he no longer needs to take antiretroviral therapy that he has had for over 30 years,” Dr. Jana Dickter, City of Hope associate clinical professor in the Division of Infectious Diseases, said during a presentation of the case at the AIDS 2022 conference.
Thousands more Americans may be living with HIV after testing was reduced during the pandemic
Thousands more Americans may be living with undiagnosed HIV than before Covid struck, official figures have suggested, in a warning sign that the devastating virus is spreading again in the United States.
The annual surveillance report of the Centers for Disease Control and Prevention (CDC) reports that new diagnoses fell by about two percent each year since 2016. But in 2020, the latest available data, they tumbled 17 percent to 30,000 new cases – which was 5,000 less than would be expected based on previous trends.
At the same time, the number of CDC-funded swabs for the virus fell by half from 2.4 to 1.2 million, one of the lowest numbers on record, leading officials to fear that many cases have gone undetected.
In its report, the agency said the ‘steep reduction’ in new cases was ‘likely due to disruptions in clinical care, patient patience… and shortages in HIV testing reagents/materials’. Bruce Packett, director of the American Academy of HIV Medicine, told DailyMail.com that it was ‘highly likely’ that thousands of cases were being missed.
He warned that – in line with other sexually transmitted diseases – cases of HIV may now be ‘level’ or ‘even increasing’, in a reversal of the slow decline since the past four years. The CDC warns other STIs like gonorrhea and syphilis may already be at record highs.
America currently aims to eradicate the transmission of HIV in just eight years, but experts say, although this was the ‘right’ target group to hit it, it was ‘set back’ by the pandemic.
“He saw many of his friends die of AIDS in the early days of the disease and faced so much stigma when he was diagnosed with HIV in 1988. But now he can celebrate this medical milestone.”
Robert Stone, President and CEO of City of Hope, said: ‘We are proud to have played a role in helping the City of Hope patient achieve remission for both HIV and leukemia. It is humbling to know that our pioneering science in bone marrow and stem cell transplants, along with our pursuit of the best precision medicine in cancer, has helped transform this patient’s life.
‘The entire team at City of Hope is honored to make a difference every day in the lives of people with cancer, diabetes and other life-threatening illnesses.’
The most recent official data show estimates that 1.2 million people in the US suffer from HIV, with about one in eight not knowing they are infected.
There were approximately 34,800 new infections in 2019. While the figure is high, it is still around a 70 percent reduction from the height of the AIDS crisis in the 1980s. The figure has also gradually dropped over time.
Many use antiretroviral drugs that prevent the virus from developing into full-blown AIDS, but still have to live with HIV for the rest of their lives.
Although this treatment is promising and can give hope to many of the people who suffer, the applications are relatively limited.
The danger of the procedure means that it is only ethical to perform it on people who are already likely to die anyway.
Still, experts hope that breakthroughs made in recent months could lead to better treatments for the virus.
“The case of the City of Hope patient, if the right donor can be identified, could open up the opportunity for more elderly patients living with HIV and blood cancers to receive a stem cell transplant and go into remission for both diseases, ” said Dicker.
Other forms of treatment have also been developed. A woman in New York received a ‘haploidentical cord transplant’, in which umbilical cord blood and bone marrow from the donor are used.
Her body responded well to the treatment, the doctors reported, and she quickly saw positive results.
Despite leaving HIV treatment more than a year ago, the virus has not resurfaced in her. Repeated scans of her body show no HIV cells with the potential to replicate and her cells could not be infected in a laboratory setting.
Like the City of Hope patient, the procedure performed on her is risky and cannot be replicated on patients who are not already in a dire situation.
WHY MODERN MEDS MEAN HIV IS NOT A DEATH SENTENCE
Before 1996, HIV was a death sentence. Then anti-retroviral therapy (ART) was created to suppress the virus. Now a person can live as long a life as anyone else, regardless of HIV.
Drugs were also invented to reduce an HIV-negative person’s risk of contracting the virus by 99%.
In recent years, research has shown that ART can suppress HIV in such a way that it does not make the virus transmissible to sexual partners.
That has spurred a movement to reduce the crime of infecting a person with HIV: it leaves the victim on lifelong, expensive medication, but it doesn’t mean certain death.
Here’s more about the new life-saving and preventive drugs:
1. Drugs for HIV-positive people
It suppresses their viral load so the virus is not transmissible
In 1996, anti-retroviral therapy (ART) was discovered.
The drug, a triple combination, transformed HIV from a fatal diagnosis to a manageable chronic condition.
It suppresses the virus, preventing it from developing into AIDS (Acquired Immunodeficiency Syndrome), which makes the body unable to resist infections.
After six months of religiously taking the daily pill, it suppresses the virus to such an extent that it is not detectable.
And once a person’s viral load is undetectable, they cannot transmit HIV to anyone else, according to numerous studies, including a decade-long study by the National Institutes of Health.
Public health organizations around the world now recognize that U = U (undetectable equals untransmissible).
2. Drugs for HIV-negative people
It is 99% effective in preventing HIV
PrEP (pre-exposure prophylaxis) became available in 2012.
This pill works like ‘the pill’ – it is taken daily and is 99 percent effective in preventing HIV infection (more effective than the contraceptive pill is in preventing pregnancy).
It consists of two drugs (tenofovir dosproxil fumarate and emtricitabine). These drugs can mount a direct attack on every trace of HIV that enters the person’s bloodstream, before it is able to spread through the body.
‘City of Hope’ patient, 66, is cured of HIV after receiving dangerous stem cell treatment Source link ‘City of Hope’ patient, 66, is cured of HIV after receiving dangerous stem cell treatment