Doctors say they probably cured another person of HIV using a specialized form of stem cell transplant. The patient has been HIV-free for six years and is the first known woman to have successfully undergone the procedure. Doctors have used a new technique of simultaneously transplanting stem cells from a parent and donor umbilical cord blood, a technique that could make such transplants more widely feasible.
The patient’s doctors detailed earlier his pending case at a scientific conference on HIV last year. Thursday they published a peer-reviewed article on his case in the journal Cell. Following the tradition of other patients who have been treated and likely cured with donor stem cells, the woman is only identified as the New York patient. She is considered one of the five persons who have been successfully treated this way, although it is still early to know for sure in some of these cases. She is the first woman of color in this exclusive group, identifying as mixed race.
According to the newspaper, the woman’s HIV was well controlled once diagnosed. Unfortunately, four years after her diagnosis, she also developed acute myeloid leukemia, a form of cancer that affects white blood cells. However, the combination of the two illnesses made her a suitable candidate for a unique procedure. Stem cell transplants are often used to treat leukemia because they can restore a person’s immune system after treatment that tries to eradicate the cancer. By transplanting stem cells from someone who carries a mutation that makes them naturally resistant to HIV infection into someone who is also HIV-positive, the hope is that you can transfer that resistance as well, allowing their body to permanently get rid of the virus.
To date, these transplants have largely relied on stem cells taken from adult donors who carry the mutation, called CCR5-delta32/32. But the woman has been enrolled in a study that is testing the use of cord blood, the IMPAACT test P1107. Donor stem cell transplants require match between donor and recipient, and compatible adults with CCR5-The delta32 mutation is a particularly rare type of donor. But donor stem cells taken from umbilical cord blood need only partially match the recipient, which should make it a more practical option. This is especially important for racially diverse populations, as they are much less likely to find someone compatible in the first place. To improve the procedure’s chances of success, doctors also transplanted stem cells from a family member who partially matched the woman, with these cells intended to act as a temporary bridge before the other stem cells are fully rebuild their immune system.
The woman received the transplant in August 2017. She has since experienced complications possibly related to the procedure (mostly asymptomatic infections), but her HIV level remained undetectable while she was undergoing treatment. About three years later, doctors decided to completely stop HIV treatment. Today, nearly six years after the transplant, the woman still shows no signs of her cancer or HIV infection returning.
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“This woman is doing exceptionally well. She is free of cancer and HIV, and travels and enjoys his life,” study author Yvonne Bryson, a researcher at the University of California, Los Angeles, told Gizmodo in an email. Other team members include physician-researchers from Johns Hopkins University, Weill Cornell Medicine, and New York-Presbyterian Hospital.
These treatments are unfortunately not scalable in stand-alone mode HIV cure. Stem cell transplants are a risky procedure that can lead to serious and even life-threatening complications. These risks are outweighed by the benefits they may bring to some people with leukemia or similar conditions, but not to the average person living with HIV, which can be effectively managed with medication.
However, in people living with HIV who develop these conditions, these transplant procedures could very well become a two-for-one remedy. Right now it’s a major challenge to find compatible people, but if rope blood is proving to be a reliable source of these unique stem cells, which should open up the donor pool. It is also possible only in progress research will one day lead to treatments that can create this HIV resistance in people without the use of a transplant, says Bryson.
“Potentially in the future there will be ways to make one’s own resistant cells—I.e. genetical therapy, etc.-or for combine the viral reduction tanks with alternating currentcaused host resistance by HIV vaccine immunotherapy,” she said.
The authors note in the article that another person had this procedure, but the transplant failed after a year. The man’s cancer returned and he continued to show signs of HIV in his system. So scientists may still need to find ways to improve its success rate. Another concern is finding and establishing an adequate supply of these rare cord blood donors. With their current protocol, THE the team was able to identify 300 units of cord blood, enough to help someone right away need a transplant. But they say that community support And Governments will be needed to ensure a continuous pipeline.
This article has been updated with comments from one of the study’s authors.