Two additional cases of curing HIV through otherwise indicated stem cell transplant were reported at AIDS 2026 this year, bringing the total number of cured HIV cases reported to date to 13. One of these cases, the “Essen patient” occurred despite complex virologic conditions and being the first with mixed HIV-1 tropism, reported Carina Elsner, of the Institute for Virology at University Medicine Essen in Essen, Germany.

“This is providing new insights into the role of viral tropism in HIV cure,” Elsner told attendees. “The key question is: Is the presence of this CCR5-delta32 mutation really the key to achieving an HIV long-term remission,” or can it be achieved without that?

The first cure case, the “Berlin patient” Timothy Ray Brown, underwent stem cell transplants in 2007-2008 to treat his acute myeloid leukemia (AML). Like most of the other cure cases, Brown had two copies of the CCR5-delta32 mutation that confers HIV-1 resistance, and his donor also had two copies of the CCR5-delta32 mutation.

The first successful cure in a patient with CCR5-wild type tropism was the Geneva patient, who received a transplant to treat myeloid sarcoma from a donor with two CCR5-wild type copies. However, none of the cure cases to date have had CXCR4 tropism.

Mutation in Cured Patient

The Essen patient case reported by Elsner had mixed HIV-1 tropism, with the virus using both the CCR5 and CXCR4 receptors. He tested positive for HIV in 2003, presenting with a CD4 count of 146 cells/ul at CDC stage B3 and a resolved hepatitis B infection.

He was diagnosed in 2010 with B cell chronic lymphocytic leukemia (B-CLL), and he underwent an allogeneic hematopoietic stem cell transplantation (allo-HSCT) in 2020 at age 61 from a 40-year-old male donor with a double CCR5-delta32 mutation. He then began antiretroviral therapy (ART) with tenofovir alafenamide/emtricitabine/bictegravir (TAF/FTC/BIC) and had no detectable HIV-1 viral load.

At 28 months after his transplant, an HIV DNA reservoir analysis revealed 7.4 copies/10⁶ cells but no replication-competent HIV-1 detectable by quantitative viral outgrowth assay. At 42 months after his transplant, biopsies taken during a colonoscopy showed no detectable proviral HIV DNA.

He began analytical treatment interruption (ATI) at 51 months after his transplant and has shown no detectable HIV-1 RNA through the time of reporting, approximately 60 weeks later.

At the same time, however, the Essen patient experienced a hepatitis B rebound at 3.5 weeks after ATI initiation. At 11 weeks, the hepatitis B genotype A2 was identified and was replication-competent. The patient tested positive for hepatitis B surface antigens at 15 weeks and showed transient elevation in liver enzymes at 31 weeks post-transplant. At 35 weeks, he showed HBeAg seroconversion.

“We still are in the phase where we cannot detect anti-HBs, but HBV functional cure might be still possible,” Elsner said. The patient is in complete remission from B cell lymphoma.

This case was important in showing “that this strategy was successful even in the face of complex virological conditions, including chronic hepatitis B which was controlled successfully after transplant with entecavir,” Monica Gandhi, MD, MPH, a professor of medicine at the University of California San Francisco, told Medscape Medical News.

Youngest Patient Cured So Far

The other cure case reported, the Kansas City patient, is the youngest person to be cured of HIV.

“This is still a single patient case, but it adds to the list of patients that have recovered following stem cell transplantation,” Wissam El Atrouni, MD, an associate professor of medicine at the University of Kansas Medical Center, Kansas City, Kansas, told attendees.

The patient was diagnosed with HIV in 2018 with a viral load of 2 million copies/mL and a CD4 count of 23. He began ART with an augmented regimen of raltegravir, emtricitabine, tenofovir alafenamide, and boosted darunavir, which was later simplified to Biktarvy (BIC/FTC/TAF). Like the other cure cases before the Essen patient, his HIV was CCR5-tropic.

He was diagnosed with undifferentiated AML in June 2020 at age 21 and underwent a hematopoietic allogeneic stem cell transplant from a matched donor who carried two copies of the CCR5-delta32 mutation.

“Unfortunately, he did not engraft very well after stem cell transplant, remained transfusion-dependent and thrombocytopenic, and required a stem cell boost from the same donor 4 months after transplant,” Atrouni reported. “After that, he achieved 100% donor polymorphism and became transfusion independent.”

He also experienced graft-vs-host disease despite sirolimus prophylaxis and therefore required prednisone treatment. Other complications included bacteremia, febrile neutropenia episodes, oral mucositis, hemoperitoneum, acute kidney injury, cytomegalovirus viremia, BK virus hemorrhagic cystitis, and invasive fungal sinusitis with fusarium requiring surgical debridement when he had no platelets and was on a platelet drip in the ICU.

Prior to ATI, he had three viral load blips within 3 months after his transplant but then had an undetectable viral load starting in late January 2021. He began ATI in February 2025 and continues to have no detectable viral load 17 months later.

“These two cases just add to the growing evidence that stem cell transplant among those with HIV with the need for this procedure due to leukemia or lymphoma with cells from individuals who are missing the CCR5 receptor is an effective strategy to achieve remission,” Gandhi said.

“Of course, we cannot use stem cell or bone marrow transplant — which poses dangers to the host of immunocompromise — unless the patient really needs that procedure for cancer, so these cases are all proof of concept around the question of whether we can knock out the CCR5 cell receptor among people with HIV by other means to achieve remission, such as CRISPR technology,” she said. “All of these studies are underway, but it is exciting to see two additional cases of remission at AIDS 2026.”

Elsner reported having no disclosures and did not note additional funding beyond the institutions of the authors. Atrouni reported serving on a ViiV advisory board and did not report any external funding. Gandhi reported having no disclosures. 

Tara Haelle has covered science and medicine for nearly two decades and is author of Vaccination Investigation and The Informed Parent: A Science-Based Resource for Your Child’s First Four Years. She is based in Dallas.