A newly documented case of long-term HIV remission is reshaping scientific understanding of what it takes to functionally cure the virus. Researchers have reported an exceptionally rare outcome: more than six years of treatment-free HIV remission in a patient who underwent a stem cell transplant without the previously assumed key ingredient for a cure—complete CCR5Δ32 mutation–driven resistance.
To date, only six people out of the estimated 88 million who have contracted HIV since the start of the epidemic have achieved a confirmed cure. All known cures have involved allogeneic stem cell transplants (allo-SCT), usually performed to treat blood cancers, with the famous “Berlin patient” being the first. For years, scientists believed that donors carrying a homozygous CCR5 Δ32 mutation, which blocks HIV from entering cells, were essential for eliminating the virus without antiretroviral therapy (ART).
However, this new case provides strong evidence that HIV remission can be achieved independently of full CCR5-mediated resistance.
The patient—a man living with HIV and diagnosed with acute myeloid leukemia—received an allo-SCT from an unrelated but HLA-matched donor who, like him, was heterozygous for the CCR5 Δ32 mutation. This means neither the patient nor the donor had the full genetic mutation previously thought necessary to block HIV infection.
Three years after the transplant, the patient discontinued ART. More than six years later, he continues to show undetectable HIV levels, with no plasma viral RNA and no replication-competent virus detected in blood or intestinal tissues.
Before the transplant, intact HIV proviruses were present in his body, but post-transplant testing revealed no surviving virus. Immune markers also shifted: HIV-specific antibodies and T-cell responses dropped sharply or disappeared, signaling no ongoing viral activity. Researchers believe that high antibody-dependent cellular cytotoxicity (ADCC) at the time of transplantation may have played a role in clearing the viral reservoir.
The findings mark a significant scientific milestone, showing that a complete CCR5Δ32 mutation may not be essential for long-term remission. Instead, they underscore the growing importance of strategies aimed at dramatically reducing or eliminating HIV reservoirs.
Experts say this case could broaden future approaches to HIV cure research—offering new hope beyond the narrow genetic pathway once considered the only route to success.
