New York patient becomes first woman to be ‘cured of HIV’
New York patient becomes first woman to be ‘cured of HIV’
New York patient becomes first woman to be ?cured of HIV?
A woman who had leukemia and was HIV-positive appears to have become the third person ever to be cured of HIV, according to the National Institutes of Health.
At a ‘Conference on Retroviruses and Opportunistic Infections’ held virtually on Tuesday February 15, it was announced that the lady who is of “mixed race”, received treatment at the New York-Presbyterian Weill Cornell Medical Center in the US.
She was said to have been diagnosed with HIV in 2013, and also confirmed to have leukemia in 2017.
In a clinical trial, scientists used a new stem cell transplant method that left the woman, who has not been publicly identified, without the virus in her system. She is the third person to achieve HIV remission and was treated with cord blood stem cells, which are more widely available than the adult stem cells used in the other two people, who were both men.
Dr. Jingmei Hsu, a stem cell transplant specialist with Weill Cornell Medicine, was the transplant doctor for the woman. She said the treatment appears to have cured the patient’s leukemia and also appears to have cured her HIV.
“Transplant was able to replace patient’s blood immune system so the HIV virus can no longer infect the patient,” Hsu said. “So far, we’re not detecting any HIV.” However, Hsu stopped short of saying the patient has definitely been cured of HIV.
“As far as we can tell at this point, we still cannot say — I will not say completely cured, but possibly cured,” Hsu said.
Hsu said stem cells from umbilical cord blood would not be used to treat just HIV. It is used to treat cancer but apparently has produced an added benefit for the patient with HIV. In addition, the umbilical cord blood does not need to be matched as closely to a recipient as stem cells used in bone marrow transplants.
An NBC news report read;
“The procedure used to treat the New York patient, known as a haplo-cord transplant, was developed by the Weill Cornell team to expand cancer treatment options for people with blood malignancies who lack HLA-identical donors.
“First, the cancer patient receives a transplant of umbilical cord blood, which contains stem cells that amount to a powerful nascent immune system. A day later, they receive a larger graft of adult stem cells. The adult stem cells flourish rapidly, but over time they are entirely replaced by cord blood cells.”
This case is the first to use umbilical cord blood cells and the first to treat someone who is multi-racial.
Scientists found no traceable sign of HIV in her system for 37 months after the transplant took place. They then took her off ART and found that she had no HIV in her system for 14 months and counting. The scientists noted that they detected “trace levels of HIV DNA” in her blood cells 14 weeks after she was taken off ART but did not detect the virus itself.
In all three cases in which HIV is believed to have been cured, the stem cell donors had a genetic mutation known as CCR5-Δ32 that prevented the HIV virus from entering cells. About 1% of humans of European descent are believed to carry the CCR5-Δ32 mutation, The Atlantic reported.
Cord blood is more widely available than the adult stem cells used in the bone marrow transplants that cured the previous two patients, and it does not need to be matched as closely to the recipient. Most donors in registries are of Caucasian origin, so allowing for only a partial match has the potential to cure dozens of Americans who have both H.I.V. and cancer each year, scientists said.
A bone marrow transplant is not a realistic option for most patients. Such transplants are highly invasive and risky, so they are generally offered only to people with cancer who have exhausted all other options.
There have only been two known cases of an H.I.V. cure so far. Referred to as “The Berlin Patient,” Timothy Ray Brown stayed virus-free for 12 years, until he died in 2020 of cancer. In 2019, another patient, later identified as Adam Castillejo, was reported to be cured of H.I.V., confirming that Mr. Brown’s case was not a fluke.
Both men received bone marrow transplants from donors who carried a mutation that blocks H.I.V. infection. The mutation has been identified in only about 20,000 donors, most of whom are of Northern European descent.
In the previous cases, as the bone marrow transplants replaced all of their immune systems, both men suffered punishing side effects, including graft versus host disease, a condition in which the donor’s cells attack the recipient’s body. Mr. Brown nearly died after his transplant. Mr. Castillejo’s treatment was less intense, but in the year after his transplant, he lost nearly 70 pounds, developed a hearing loss and survived multiple infections, according to his doctors.
By contrast, the woman in the latest case left the hospital by day 17 after her transplant and did not develop graft versus host disease, said Dr. JingMei Hsu, the patient’s physician at Weill Cornell Medicine. The combination of cord blood and her relative’s cells might have spared her much of the brutal side effects of a typical bone marrow transplant, Dr. Hsu said.
The sex and racial background of the new case mark a significant step forward in developing a cure for H.I.V., the researchers said.
“The fact that she’s mixed race, and that she’s a woman, that is really important scientifically and really important in terms of the community impact,” said Dr. Steven Deeks, an AIDS expert at the University of California, San Francisco who was not involved in the work.
But Dr. Deeks said he did not see the new approach becoming commonplace. “These are stories of providing inspiration to the field and perhaps the road map,” he said.
Powerful antiretroviral drugs can control H.I.V., but a cure is key to ending the decades-old pandemic. Worldwide, nearly 38 million people are living with H.I.V., and about 73 percent of them are receiving treatment.
