Specialists from the Institute for AIDS Research IrsiCaixa in Barcelona and the Gregorio Marañón Hospital in Madrid have detected stem cell transplantation that could lead to the eradication of HIV in the body.
The study, published in the journal ‘Annals of Internal Medicine’, have revealed that five people infected with HIV who received a stem cell transplant have the virus undetectable in blood and tissues, and one of them does not even have antibodies against the virus in the blood, which seems to indicate that HIV could have been eliminated.
“This fact could be proof that HIV is not longer in your blood, but you can only confirm the treatment and checking whether the virus reappears or not,” said co-author of the article Maria Salgado, in a statement both centers.
The work indicates that the origin of the stem cells, the time in which the complete replacement of the recipient’s cells, and the disease of the graft against host, could have contributed to a potential death of HIV.
“Our goal is to elucidate the factors that help to eradicate the virus after transplantation and then imitate them with alternative strategies to this intervention”, concluded the study’s colleague, Javier Martinez-Picado, ICREA research professor at IrsiCaixa and co-director of the IciStem consortium -in which it has been carried out-.
The next step will be to conduct a clinical trial, controlled by doctors and researchers, to stop antiretroviral medication in some of these patients and provide new immunotherapies to check for viral rebound and confirm if the virus has been eradicated from the body.
The study has been based on the case of ‘The Patient of Berlin’, Timothy Brown, a man with HIV who in 2008 underwent a stem cell transplant to treat leukemia and the donor had to mutation -CCR5 Delta 32- that it made their blood cells immune to HIV, preventing the virus from entering them.
The man stopped taking antiretroviral medication and, 11 years later, the virus still does not appear in his blood, so he is considered the only person in the world cured of HIV, and since then scientists are investigating possible mechanisms to eradicate HIV. HIV associated with stem cell transplantation.
The IciStem consortium has created a cohort “unique in the world” of people infected with HIV who underwent a transplant to cure a blood disease, with the ultimate goal of designing new strategies for cure.
Our hypothesis was that, in addition to the CCR5 Delta 32 mutation, other mechanisms associated with transplantation influenced the eradication of HIV in Timothy Brown, said Salgado, a researcher at IrsiCaixa-a center run by Obra Social La Caixa and the Ministry of Health. Health of the Generalitat-.
This study included six participants who had survived at least 2 years after receiving the transplant and did not have CCR5 Delta 32 in their cells:
“We selected these cases because we wanted to focus on the other possible causes that could help eliminate the virus “, You have highlighted the hematologist of Gregorio Marañón Mi Kwon, coprimera author.
After the transplant, all the participants maintained the antiretroviral treatment and achieved the remission of their hematological disease after the withdrawal of immunosuppressive drugs.
After several analyzes, the researchers saw that five of them had a viral reservoir – infected cells that remain in a latent state – undetectable in blood and tissues, a relevant fact because these parameters are always detectable in people infected with HIV, even if they take antiretroviral medication.
In addition, in one of the participants, the viral antibodies had completely disappeared seven years after the transplant.
About the process in which all the cells are replaced by those of the donor after the transplant -which can last between a month and more than a year-, the researchers have detected that, “the
In graft-versus-host disease, which occurs when there is no detectable reservoir did not have this reaction.
“This suggests that if we manage to control this effect, it is not fatal,” said research colleague José Luis Diez-Martin, of the Madrid hospital.
