Remarkable HIV Cure in Norway
A 63-year-old man in Norway has reportedly received an extraordinary gift from his brother: a potential cure for his long-standing HIV infection. This surprising development was outlined in a case report released this week. Initially, the brother donated his stem cells to help treat the man’s serious blood cancer, but he also carried a rare genetic mutation that offers a natural immunity to HIV. Four years post-transplant and two years after stopping antiretroviral therapy, the man still shows no signs of the infection.
“For all practical purposes, we are quite certain that he is cured,” said Anders Eivind Myhre, one of his doctors, during a conversation with AFP on Monday.
The Oslo Patient
Today’s medications have transitioned HIV from what used to be a near-certain death sentence to a manageable health issue. With ongoing treatment, it’s even possible to prevent the virus from being transmitted to others. Nonetheless, HIV remains a lifelong condition, and ceasing treatment usually leads to the virus re-emerging within weeks or months.
In recent years, medical professionals have demonstrated that it might be feasible to eliminate lingering traces of a managed HIV infection through stem cell transplants. HIV predominantly targets certain white blood cells, and the transplant aims to rebuild the person’s immune system. The stem cells effectively replace the recipient’s bone marrow, which is critical for blood and immune cell production.
In these instances, individuals are typically identified by their geographic location during treatment, although some have eventually chosen to reveal their identities. In this current case, the man has been referred to as the “Oslo patient.”
The report reveals that he was initially diagnosed with myelodysplastic syndrome—a type of cancer affecting bone marrow blood cell production—in 2018. While he seemed to respond well to treatments at first, the cancer returned, prompting doctors to consider a stem cell transplant.
Since he had also been diagnosed with HIV back in 2006, the medical team aimed to tackle both health issues simultaneously, albeit they were aware of the slim odds of success. Most prior cases that achieved HIV cures involved stem cells from individuals with two copies of a specific CCR5 gene mutation, known as CCR5-delta 32, which provides natural resistance to HIV-1, the most prevalent strain of the virus. Unfortunately, only about 1% of the population has two copies of this mutation.
After initial attempts to find a suitable donor with the mutation failed, the doctors moved forward with the brother, who was known to have compatible bone marrow. To everyone’s surprise, testing on transplant day confirmed that the brother also had the mutation.
While the man faced some complications from the procedure, his body began to produce new blood cells exhibiting the mutation. Two years later, following the transplant, he was taken off antiretroviral medications. Since then, routine follow-up tests have shown no signs of the virus in his bloodstream.
Lessons Learned
The likelihood of this particular case occurring is indeed astonishing. Ignoring the rarity of the mutation in the general population, siblings typically match for compatible bone marrow only about a quarter of the time. According to AFP, there have been around ten recorded cases worldwide of HIV being cured through stem cell transplants, and this is the first involving a family donor.
The Oslo patient himself feels incredibly fortunate, remarking that “it was like winning the lottery twice,” according to Myhre’s comments to AFP.
Unfortunately, stem cell transplants aren’t a practical solution for curing HIV on a large scale. The procedure carries significant risks and can even be fatal, which limits its use to extreme cases of blood cancers that lack other treatment options. Nevertheless, this procedure can provide a fresh start for some individuals battling both conditions. Additionally, this case offers valuable insights for medical professionals striving to find a definitive cure for HIV.
“The case of the Oslo patient contributes valuable evidence to the existing knowledge base regarding HIV cure cases,” the doctors noted in their article, published in Nature Medicine on Monday.
