The healthcare team at the AP-HM Information and Care Center for Human Immunodeficiency and Viral Hepatitis (CISIH) detailed the very rare case of HIV remission for a patient monitored in the department. First in France and eighth case in the world.
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The case of this patient, aged around sixty, opens up new research perspectives to fight AIDS. Followed at the Sainte-Marguerite hospital in Marseille, she was declared in remission after an allogeneic bone marrow transplant performed five years ago. This would be the first case of cure for HIV in France. The eighth case in the world.
Diagnosed with HIV in 1999, the sixty-year-old had “developed acute myeloid leukemia in 2020”explained the Assistance Publique-Hôpitaux de Marseille, in a press release. The AP-HM specifies, however, that this case is not “generalizable to all patients affected by HIV due to the burden of treatments associated with allograft”.
Doctor Sylvie Bregigeon who directs the Information and Care Center for Human Immunodeficiency and Viral Hepatitis (CISIH), where this patient is being followed, and Doctor Olivia Eaegel-Faucher detail these results to the press this Monday January 20.
To date, only seven cases of functional cure of HIV after allogeneic bone marrow transplantationthree in Germany, two in the United States, one in Great Britain. The latest, in Geneva, Switzerland in 2023. All of these patients had an indication for transplants to treat acute leukemia, treatments which are rarely used in patients with HIV, explained Sylvie Bregigeon.
The pProfessor Philippe Colson, hospital practitioner at IHU Méditerranée Infection, emphasized that this transplant treatment used for malignant hemopathy was only possible with a donor qwho had a rare genetic mutation. Che donor had a rare genetic mutation (Delta 32) on the CCR5 gene, preventing HIV from attaching to it and destroying the cells. Bone marrow transplant treatment is not applicable on a large scale to all HIV patients. The percentage is estimated at 1% of cases.
“There is not one method suitable for HIV patients”insisted Professor Colson, what is very rare is finding a compatible donor who presents the necessary mutation. There is a one in a million chance of finding a compatible donor who has the right mutation, said the Dr Faezeh Legrand, phospital ratician in hematology – IPC. Hence only eight cases of remission to date in the world.
-“And it doesn’t work every time, even with a mutated donor,” warns Dr. Bregigeon.
Professor Colson recalled that bone marrow transplantation is a very heavy treatment, which presents numerous complications for the patient, particularly infectious ones.
This allograft treatment was not offered to the IPC patient for her HIV, but for her acute leukemia. “The first objective was to cure her of the leukemia from which she would die,” added Doctor Olivia Eaegel-Faucher. Today, “the patient is doing well, she is very happy”indicated Dr. Bregigeon.
This case of exceptional cure with very specific criteria is important for future research for HIV patients, but also because it shows “that we can treat these patients with optimal treatments such as an allograft in the case of a hematological malignancy”.
The patient, originally from the Paca region, wishes to remain anonymous and did not attend this press presentation. THE Dr Faezeh Legrand, who treated her for her transplant, read a message that she wanted to convey to patients, researchers and the entire medical team.
“After 26 years of illness, I never thought that one day I would be able to hear such news, it is such a relief and such a message of hope for all the people who are in the same situation”she writes.
“I have a very special thought for the person who made this bone marrow donation, which allowed not only a total cure of leukemia, but even more to achieve what I thought was impossible, to defeat HIV “.
“I would like to tell all the sick that the road is long and strewn with pitfalls, but that if we are well surrounded and taken care of, we can still believe in it, see the dawn of recovery,” she concludes.
