She is only the third HIV patient cured using a novel treatment. Researchers claimed that the new technique has the potential to cure more patients from varied racial origins.
Scientists reported on Tuesday that a lady of mixed race looks to be the third HIV patient cured using a novel transplant approach utilizing umbilical cord blood, which opens up the potential of healing more people of varied racial origins than was previously conceivable.
Cord blood is more commonly available than adult stem cells, which were utilized in the bone marrow transplants that healed the previous two patients, and it does not require as tight matching to the recipient. The majority of registries’ donors are Caucasian, therefore allowing for merely a partial match has the potential to treat hundreds of Americans with HIV and cancer each year, according to experts.
The woman, who was also suffering from leukemia, was given cord blood to help her fight her disease. Instead of the usual process of identifying a bone marrow donor of the same color and ethnicity as the patient, it came from a partly matched donor. She also got blood from a close relative to provide her body with temporary immunological protection while the operation was being performed.
On Tuesday, at the Conference on Retroviruses and Opportunistic Infections in Denver, Colo., researchers shared some of the specifics of the new case.
The new case’s sex and racial origin represent a big step forward in the development of an HIV cure, according to the researchers.
“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 study.
HIV infection is assumed to proceed differently in women than in males, yet despite the fact that women account for more than half of all HIV infections worldwide, they make up just 11% of cure trial participants.
Dr. Deeks, on the other hand, does not believe the new strategy will become widespread. “These are stories of offering inspiration and maybe a road map to the field,” he added.
HIV can be controlled with powerful antiretroviral medications, but a cure is needed to halt the decades-long pandemic. Nearly 38 million individuals worldwide are infected with HIV, with 73 percent of them undergoing treatment.
For most people, a bone marrow transplant is not a viable choice. Because such transplants are extremely intrusive and hazardous, they are often reserved for cancer patients who have exhausted all other alternatives.
Two other HIV patients cured using novel treatment were documented
Only two cases of HIV patients cured of the infection have been documented thus far. Timothy Ray Brown, often known as “The Berlin Patient,” was a virus-free patient for 12 years until succumbing to cancer in 2020. Another patient, Adam Castillejo, was cured of HIV in 2019, proving that Mr. Brown’s case was not a fluke.
Both guys had bone marrow transplants from donors who had an HIV infection-blocking mutation. Only roughly 20,000 donors, the majority of whom are of Northern European ancestry, have been identified with the mutation.
Both men suffered from graft versus host disease, a condition in which the donor’s cells attack the recipient’s body, in the prior cases, as the bone marrow transplants replaced all of their immune systems. Mr. Brown was on the verge of death following his transplant. Mr. Castillejo’s therapy was less intensive, but he lost roughly 70 pounds, had hearing loss, and survived many infections in the year following his transplant, according to his physicians.
According to Dr. JingMei Hsu, the patient’s physician at Weill Cornell Medicine, the woman in the newest example was discharged from the hospital on day 17 following her transplant and did not develop graft versus host disease. According to Dr. Hsu, the mix of cord blood and her relative’s cells may have protected her from many of the gruesome side effects of a traditional bone marrow transplant.
Dr. Sharon Lewin, president-elect of the International AIDS Society, who was not involved in the research, stated, ““It was previously thought that graft versus host disease might be an important reason for an HIV cure in the prior cases.” According to Dr. Lewin, the latest findings disprove that theory.
HIV patient cured using novel treatment obtained haplo cells from cousin
In June 2013, the woman, who is now past middle age (she declined to reveal her actual age due to privacy concerns), was diagnosed with HIV. Her virus levels were kept low thanks to antiretroviral therapy. She was diagnosed with acute myelogenous leukemia in March 2017.
She obtained cord blood from a donor with the mutation that prevents HIV from entering cells in August of that year. However, because cord blood cells take roughly six weeks to engraft, she was also given partly matched blood stem cells from a first-degree cousin.
According to Dr. Marshall Glesby, an infectious diseases expert at Weill Cornell Medicine of New York and a member of the study team, the half-matched “haplo” cells from her relative supported her immune system until the cord blood cells became dominant, making the transplant significantly less risky.
“The transplant from the relative is like a bridge that got her through to the point of the cord blood being able to take over,” he said.
37 months after the transplant, the patient chose to stop taking antiretroviral medication. She currently has no HIV symptoms in blood testing and no detectable antibodies to the virus after more than 14 months.
Experts say it’s unknown why cord blood stem cells appear to perform so effectively. According to Dr. Koen Van Besien, director of the transplant program at Weill Cornell, one theory is that they are better at adjusting to unfamiliar environments. “These are newborns,” he explained, “they are more adaptable.”
Cord blood may include components other than stem cells that benefit in transplantation.
“Umbilical stem cells are attractive,” stated Dr. Deeks. “There’s something magical about these cells and something magical perhaps about the cord blood in general that provides an extra benefit.”