IrsiCaixa leads an international research consortium to reproduce the only successful case of a person cured of HIV16/12/2014
The only medical intervention that managed to cure a person from the HIV infection is known as the Berlin patient case. Named Timothy Brown, he underwent stem cell transplantation of bone marrow from a donor who had a rare genetic mutation, which conferred him resistance to HIV infection. This mutation is present in approximately 1% of people with European origin. The strategy raised tremendous scientific interest as it opened new prospects of viral eradication. However, this success is not scalable to cure HIV infection, as it is a high-risk procedure only indicated for HIV+ patients with life-threatening hematological disease, as it was the case of Brown.
For these patients, many researchers around the world have tried, so far unsuccessfully, to reproduce this approach, and to understand the crucial successful factors of the intervention. The rare genetic mutation of the donor, which confers resistance to HIV, seems to be the main factor for success, but there are other steps in the clinical process that may also have contributed.
A European consortium of researchers co-led by the Institute for AIDS Research IrsiCaixa and the University Medical Center Utrecht have just initiated an ambitious project to try to improve the interventions to cure these patients with the additional aim to better understand the implication of stem cell transplantation in the control and eradication of HIV infection. The project was presented to the scientific community on November at the Gesida National Congress, held in Málaga, Spain.
This team, co-led by the ICREA researcher at IrsiCaixa Javier Martínez-Picado, received a grant from the amfAR Research Consortium on HIV Eradication (ARCHE). The consortium is formed by hematologists, infectious disease specialists, virologists, and immunologists with expertise in the field of HIV, including Gero Hütter, the oncologist credited with the Berlin patient’s cure. Experts from the Catalan Institute of Oncology (ICO) and the Gregorio Marañón Hospital, in Spain, will also collaborate in this project. The Gregorio Marañón Hospital has a great experience in stem cell transplantations in HIV positive patients from all over Spain with blood related cancers.
“We need to understand the specific reasons of the HIV cure in the Berlin patient if we want to move forward in the eradication of this infection. We also want to use umbilical cord blood as a source of stem cells to increase the chances of compatibility between donors and patients”, states Martínez-Picado. Using stem cells from umbilical cord blood has a clear advantage, as they are far more compatible than the ones extracted from the bone marrow. With this new approach, the chances to find a donor that is compatible and additionally has the rare genetic mutation conferring HIV resistance is raised more than 100 fold.
In parallel, also with additional financial support from amfAR, it will be created an inventory that allows to identify which of the 10.000 cord blood units available in the North European cord blood banks contain the rare genetic mutation that confer resistance to HIV. This will allow that these units will be immediately available for transplantation. In Spain, as it was announced earlier this month, the Spanish National Transplant Organization (ONT) leads a project to identify potential high-quality stem cells in the Spanish Cord Blood Banks that may contribute to effective stem cell transplantations.
The researchers have already started to implement this strategy in HIV positive people in need of stem cell transplantation with encouraging results, whose latest results are still being evaluated. At present, the team is still enrolling patients in the study, and makes a call for physicians, researchers and citizens to find potential candidates to join the project (contact can be made through firstname.lastname@example.org).
Further information: irsicaixa.es/epistem