a French woman in remission, a feat that is difficult to generalize

The potential cure of HIV in a French patient, after a bone marrow transplant intended to save her from acute leukemia, remains “very rare” and difficult to generalize due to the heavy nature of the treatment involved, according to the Marseille medical team who followed her.

“After more than 26 years of illness, I never thought that one day I would hear such news,” said this patient, aged in her sixties, in a message read this Monday by one of the doctors who accompanied her. years, who wishes to remain anonymous. Living in the Provence-Alpes-Côte d'Azur (Paca) region, she was diagnosed with HIV in 1999 and underwent a bone marrow transplant in July 2020 after reporting acute leukemia. His donor, from the international donor file, had a rare genetic mutation (Delta 32) on the CCR5 gene, preventing HIV from entering cells.

“Genetic specificity”

“This mutation on the Delta 32 gene is very rare since it occurs in approximately 1% worldwide. So it's fortunate to have been able to find a donor compatible with the patient and who, in addition, was a carrier of this genetic specificity”, noted this Monday during a press conference in Marseille Sylvie Bregigeon, head of a specialized unit, within Marseille public hospitals (AP-HM), in the care of patients living with HIV.

“We have a one in a million chance of finding a 100% identical donor on the international file. And on the other hand, the prevalence of this genetic mutation is 10% among Caucasians,” added Doctor Faezeh Legrand, hematologist at the Paoli-Calmettes Cancer Institute. “The notion of remission is having stopped the antiretroviral treatment” of this patient since October 2023 and the fact “that currently, all the finest markers at our disposal […] are found negative,” continued Sylvie Bregigeon.

First case in France

This case of HIV remission is the first in France – even if current hindsight does not yet allow us to speak of a cure. Seven other patients who have received a bone marrow transplant around the world are considered in HIV remission: one patient in Switzerland, three patients in Germany, two patients in the United States and one patient in England.

“The most significant period of time over the seven other cases is 10 years for the first patient who was described as cured in 2008” of HIV but who died after having a relapse of his leukemia, according to Sylvie Bregigeon. However, “this treatment is not a large-scale treatment which will be applicable to all patients suffering from HIV”, insisted Professor Raynier Devillier, head of the bone marrow transplant and hematology at the Paoli-Calmettes Institute, recalling that bone marrow transplantation is “an extremely heavy treatment” and which “exposes the patient to numerous complications”. This is why “classically, [ce] is not a treatment that we offer to patients who have HIV,” he stressed.

But if, “in the past, patients living with HIV may have been somewhat excluded from certain protocols or from certain oncological therapeutic decisions, whatever the cancers”, this “must no longer be the case” because the fact of Being infected with HIV “is no longer a contraindication”, underlined Dr Bregigeon.