HIV Cure Update: Woman HIV Free 5 Years Post Stem Cell Transplant
A woman referred to as the “New York patient” underwent a stem cell transplant for HIV cure, and according to researchers, she has now been free of the virus and has not required HIV medication for roughly 30 months.
Dr. Yvonne Bryson, who oversaw the case, stated during a news conference on Wednesday (March 15) that while they have observed promising results, they are not yet ready to declare a definitive cure. Instead, they are cautiously optimistic and awaiting a longer period of follow-up before making any final conclusions.
As the director of the Los Angeles-Brazil AIDS Consortium at the University of California, Los Angeles, Dr. Bryson’s expertise in the field of HIV/AIDS research lends credibility to these findings.
According to Dr. Deborah Persaud, the interim director of pediatric infectious diseases at Johns Hopkins University School of Medicine, only a few individuals have been cured of HIV to date. As a result, there is currently no official distinction between being cured and being in long-term remission.
Dr. Persaud supervised the case of the New York patient, whose prognosis appears to be very promising. However, at this time, it is premature to determine if the patient has been cured. As Dr. Persaud stated during the news conference, the medical community is hesitant to make such a declaration.
In February 2022, Bryson and her team presented preliminary data on a patient from New York. A more comprehensive report on the case was recently published in the scientific journal Cell on March 16, which provides detailed information on the patient’s medical history until the point when she discontinued her antiretroviral therapy (ART) – a standard treatment for HIV – for approximately 18 months.
The patient underwent a stem cell transplant in August 2017 and ceased taking ART medication slightly over three years later. Currently, she has been off medication for about 2.5 years and continues to thrive, as reported by Dr. Jingmei Hsu, the director of the Cellular Therapy Laboratory at NYU Langone Health and one of the leaders of the transplant team, during a news conference. Dr. Hsu shared that the patient is enjoying her life and remains in good health.
Previous cases of HIV cure involved stem cell transplants taken from bone marrow that were intended to treat both cancer and HIV. These cases include definitive cures in men treated in London, Berlin, and Düsseldorf, as well as one instance of long-term remission in a man treated in Los Angeles. However, it’s important to note that the first patient cured of HIV – a man from Berlin – passed away in 2020 after experiencing a cancer relapse.
In all the aforementioned cases, stem cell transplants were carried out using bone marrow stem cells obtained from adult donors who possessed two copies of a unique genetic mutation called CCR5-Delta32. This genetic alteration modifies the entry point that HIV typically uses to penetrate white blood cells, thus preventing the virus from entering.
Following the transplant, the donor stem cells take over the patient’s immune system, replacing their previous HIV-susceptible cells with new, HIV-resistant ones. To enable the new immune cells to flourish, physicians use chemotherapy or radiation therapy to eliminate the patient’s original immune cell population
Similar to previous cases, the patient from New York had both cancer and HIV and was treated with chemotherapy prior to her transplant. However, she received stem cells obtained from umbilical cord blood that carried the HIV-resistant genes. The umbilical cord blood was donated by the parents of an unrelated baby at the time of birth and subsequently screened for the CCR5-Delta32 mutation.
To supplement the umbilical cord stem cells, which were limited in number, the patient was also given stem cells donated by a relative. These additional stem cells aided in filling the gap as the patient’s HIV-resistant cells began to emerge.
Given that umbilical cord blood is more readily available than adult bone marrow and has a higher rate of compatibility between donors and recipients, it’s possible that such procedures could become more prevalent in the future.
Nevertheless, stem cell transplants wouldn’t be suitable for HIV-positive patients who don’t have a second severe ailment, such as cancer, since the procedure involves eradicating the immune system, as per Bryson’s statement.