Kansas City Man Becomes Youngest Person Potentially Cured of HIV After Stem Cell Transplant
核心洞察
A 21-year-old man, dubbed the "Kansas City Patient," has achieved sustained HIV (搜索) remission 17 months after stopping antiretroviral therapy following a CCR5-delta32 (搜索) stem cell transplant for acute myeloid leukemia (搜索).
He is the youngest person ever to be potentially cured of HIV (搜索) through stem cell transplantation, with undetectable plasma HIV RNA, intact proviral DNA, and replication-competent virus.
The Essen Patient was also reported at AIDS 2026, becoming the first person with hepatitis B (搜索) co-infection to achieve HIV (搜索) remission after a similar transplant procedure.
A 21-year-old man has become the latest — and youngest — person potentially cured of HIV (搜索) after receiving a stem cell transplant from a donor carrying a rare genetic mutation that confers natural resistance to the virus, physicians reported this week at the 26th International AIDS Conference (AIDS 2026) in Rio de Janeiro.
The case, presented alongside that of the "Essen Patient" from Germany, brings the total number of people who have achieved sustained treatment-free HIV (搜索) remission following stem cell transplantation to 13. Both cases offer new biological clues that researchers hope will advance the development of more broadly accessible HIV cure strategies.
"It's exciting to see another person join the ranks of those who have achieved sustained HIV (搜索) remission without antiretroviral treatment," said International AIDS Society (搜索) President Dr. Beatriz Grinsztejn of the Oswaldo Cruz Foundation in Rio. "These transplants are high-risk procedures for life-threatening cancers — not scalable cures for HIV. However, these cases do provide important insights that help advance broader HIV cure research."
The Kansas City Patient: A Landmark in Youth
Dr. Wissam El Atrouni, an infectious disease physician at the University of Kansas Medical Center, detailed the case of a man diagnosed with HIV (搜索) in 2018 with a CD4 count of just 23. He was treated with an antiretroviral regimen that included an integrase inhibitor, a boosted protease inhibitor, tenofovir alafenamide, and emtricitabine. While his viral load became undetectable, his CD4 count mostly remained under 300.
In June 2020, at age 21, he was diagnosed with acute myeloid leukemia (搜索), making him by far the youngest person to undergo a stem cell transplant with curative intent for HIV (搜索). In October 2020, he received a transplant from an unrelated matched donor carrying two copies of the CCR5-delta32 (搜索) mutation — a genetic variant that disables the CCR5 (搜索) receptor most strains of HIV use to enter human cells.
The transplant course was arduous. The initial procedure was not completely effective, requiring a boost of stem cells from the same donor four months later. During this period, he experienced persistent low blood cell counts, E. coli and Pseudomonas aeruginosa infections, invasive fungal sinusitis, cytomegalovirus colitis, and graft-versus-host disease (GVHD). "At one point, they did not think he was going to make it out of the intensive care unit," El Atrouni noted.
Despite three HIV (搜索) viral blips after the initial transplant and before the stem cell boost, his viral load has remained undetectable since January 2021. Approximately 2.5 years after the transplant and again seven months later, intact proviral HIV DNA could not be detected in peripheral CD4 cells.
In February 2025, the man began a closely monitored analytical treatment interruption. About a year after stopping antiretrovirals, his CD4 count stabilized above 500. Now, at 17 months post-treatment interruption, plasma HIV (搜索) RNA viral load, intact proviral HIV DNA, and replication-competent virus all remain undetectable in his blood — though tissue biopsies have not yet been performed. Notably, he still has persistent HIV antibodies and HIV-specific T-cell responses, which El Atrouni suggested may reflect low-level residual HIV antigens rather than deep, undetected viral latency.
The Essen Patient: Navigating Hepatitis B Co-Infection
Dr. Carina Elsner of University Hospital Essen (搜索) in Germany presented the case of the Essen Patient, a man who tested positive for HIV (搜索) in 2003 with a CD4 count of 146 — low enough for an AIDS diagnosis. In 2010, at age 51, he was diagnosed with chronic lymphocytic leukemia (搜索). A decade later, after conditioning chemotherapy and whole-body radiation, he received a stem cell transplant from an unrelated matched donor with two copies of the CCR5-delta32 (搜索) mutation.
This case is notable because the man harbored mixed-tropic HIV (搜索), meaning some virus used the CCR5 (搜索) receptor while other strains used the CXCR4 (搜索) coreceptor — theoretically, a transplant with CCR5-mutated stem cells might not protect against CXCR4-tropic virus. Yet at 51 months post-transplant, he stopped antiretroviral therapy, and approximately 14 months later, his HIV viral load remains undetectable. "The presence of some CXCR4-tropic virus did not preclude long-term remission," Elsner observed.
The case also marks the first HIV (搜索) cure involving hepatitis B (搜索) co-infection. The man experienced HBV reactivation 25 days after stopping his antiretroviral regimen, which had included tenofovir alafenamide with dual activity against both viruses. About 15 weeks into the treatment interruption, he tested positive for HBsAg. At approximately 21 weeks, he started entecavir, an antiviral active against HBV but not HIV. Around 35 weeks, he experienced HBeAg seroconversion indicating remission. While he does not yet have hepatitis B surface antibodies, he has developed HBV-specific T cells, suggesting his newly reconstituted immune system may enable a functional cure of hepatitis B.
The Growing Ranks and Unanswered Questions
The two new cases join a distinguished list: Timothy Ray Brown (the Berlin Patient), Adam Castillejo (the London Patient), Marc Franke (the Düsseldorf Patient), Paul Edmonds (the City of Hope Patient), and others. Brown, the first person ever cured of HIV (搜索) through stem cell transplantation, remained in HIV remission for more than a decade before his death in 2020 following a leukemia recurrence.
Researchers continue to investigate why some stem cell transplant recipients achieve HIV (搜索) remission while others do not. Initially, experts attributed Brown's cure to the double CCR5-delta32 (搜索) mutation, but subsequent cases have complicated this picture. The New York Patient was cured using umbilical cord blood cells with the mutation combined with partially matched adult stem cells without it. The next Berlin Patient had only a single copy of the mutation. And Romuald, the Geneva Patient, appears cured after receiving wild-type stem cells with no copies of the mutation at all.
The role of GVHD and conditioning regimen intensity also remains unclear, with some cured patients experiencing severe GVHD and intensive conditioning while others did not.
"What we need to do is figure out how to produce the same result by making cells safe from reinfection by modifying receptors without the need for aggressive radiation and chemotherapy," said Professor Joseph Eron of the University of North Carolina at Chapel Hill. Researchers are now exploring gene editing approaches to disable or delete CCR5 (搜索) receptors on susceptible immune cells, potentially offering a path toward more widely applicable HIV (搜索) cure strategies.