‘Oslo Patient’ Shows Long-term HIV Remission Following Stem Cell Transplant

A 63-year-old man may represent the 10th reported case of sustained HIV remission following allogeneic hematopoietic stem cell transplantation (HSCT), according to results of a study published in Nature Microbiology. The transplant was performed to treat the patient’s myelodysplastic syndrome and the donor (the patient’s HLA-identical brother) carried a homozygous CCR5Delta32 mutation that prevents HIV from entering CD4+ cells.

The patient achieved full donor chimerism in peripheral blood by day 90 and in bone marrow at 48 months post-transplant. Investigators also documented full donor chimerism in gut-associated lymphoid tissue, a major HIV reservoir not evaluated in prior cure cases.

After discontinuing antiretroviral therapy under medical supervision, the patient has remained without detectable HIV RNA for 36 months. Additional testing found no intact proviral DNA in blood or gut tissue and no replication-competent virus in more than 65 million CD4+ T cells.

While the findings suggest sustained HIV remission in this patient, investigators cautioned that HSCT is not a scalable strategy to cure HIV due to the risk of procedure-related mortality.