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The oldest patient yet has been cured of HIV after receiving a stem cell transplant for leukemia, researchers reported on Wednesday.
While the transplant was planned to treat the now 66-year-old’s leukemia, the doctors also sought a donor who was naturally resistant to the virus that causes Aids, a mechanism that first worked to cure the “Berlin patient”, Timothy Ray Brown, in 2007.
The latest patient, the fourth to be cured in this way, is known as the “City of Hope” patient after the US facility in Duarte, California, where he was treated, because he does not want to be identified.
As well as being the oldest, the patient has also had HIV the longest, having been diagnosed in 1988 with what he described as a “death sentence” that killed many of his friends.
He has been on antiretroviral therapy (ART) to control his condition for more than 30 years.
Doctors who presented the data ahead of the International Aids Society’s (IAS) 2022 meeting said the case opened up the potential for older patients with HIV and blood cancer to access the treatment, particularly as the stem cell donor was not a family member.
Describing a cure as the “holy grail”, Sharon Lewin, president-elect of the IAS, said the “City of Hope” case provided “continued hope … and inspiration” for people with HIV and the wider scientific community, although the treatment was unlikely to be an option for most people with HIV due to the risks of the procedure.
Scientists think the process works because the donor individual’s stem cells have a specific, rare genetic mutation which means they lack the receptors used by HIV to infect cells.
After the transplant three and a half years ago, which followed chemotherapy, the City of Hope patient stopped taking ART in March 2021. He has now been in remission from both HIV and leukemia for more than a year, the team said.
But before the conference that starts on Friday, the Joint United Nations Programme on HIV/Aids (UNAids) presented data showing how the Covid-19 pandemic had derailed global efforts to tackle HIV, including a reversal of progress in the world’s most populous region, Asia and the Pacific.
Hard-won progress has stalled, putting millions of lives at risk, according to the report.
Worldwide, the years-long decline in new HIV infections is leveling off. Worse, cases began climbing in parts of Asia and the Pacific where they previously had been falling, according to UNAids.
The number of people on lifesaving HIV treatments grew more slowly last year than it has in a decade. Inequities are widening. Every two minutes last year, a teen girl or young woman was newly infected and in sub-Saharan Africa they are three times as likely to get HIV as boys and men the same age. And 650,000 people died from Aids-related illnesses last year, the report found.
“This is an alarm to the world to say that Covid-19 has blown the Aids response significantly off track,” said Matthew Kavanagh, deputy executive director of UNAids.
The UN set a goal of fewer than 370,000 new HIV infections by 2025. Last year, there were about 1.5m, meaning it would take a significant turnaround to get anywhere near that target. Yet low- and middle-income countries are $8bn short of the funding needed, as international aid also has dropped, the report found.
Things might be even worse considering that HIV testing slowed or even stopped in many places when Covid-19 hit, possibly leaving even more virus spread uncounted.
“People are exhausted with epidemics and pandemics,” said Dr Anthony Fauci, the US government’s leading Aids expert. “We have to fight twice as hard to get HIV back on the radar screen where it belongs.”