A woman in New York has become the third person, and the first woman, in the world effectively cured of HIV.
Earlier this week, UCLA researchers presented the groundbreaking case of a woman cured of HIV, at the Conference on Retroviruses and Opportunistic Infections (CROI 2022). Called the ‘New York Patient’, the woman was initially diagnosed with HIV-1 in 2013 and later developed acute myeloid leukemia (AML) in 2017. Doctors at the New York-Presbyterian/Weill Cornell Medical Center decided to treat her cancer using specialized stem cells from cord blood. As a result, the woman went into remission. Moreover, for 14 months after discontinuing antivirals, she continued to test negative for the virus. Thus, becoming only the third person in the world and the first woman cured of HIV.
This study provides hope for the use of cord blood cells or a combination of cord blood cells and haploidentical (half-matched) grafts to achieve HIV-1 remission for individuals requiring transplantation for other diseases.
Dr Yvonne Bryson, specialist in HIV pathogenesis at the David Geffen School of Medicine at UCLA
Previous two cases, both men, had received bone marrow transplants from a donor with a genetic mutation that is protective against HIV-1 (CCR5-delta32/32). The New York patient also received stem cells from a donor with the same mutation; however, doctors used umbilical cord blood from an unrelated, but genetically matched newborn. Furthermore, the woman received adult stem cells and was taking antiretroviral drugs. Eventually, she stopped taking the drugs after the stem cell transplant. 14 months later, her virus levels have remained undetectable. Moreover, the woman has been in remission of AML for over 4 years.
Why Cord Blood?
Adult donor grafts lead to rapid engraftment, but also carry a higher risk of graft-versus-host disease. According to Dr. Yvonne Bryson, cord blood grafts take longer to engraft, but they carry lower chances of complications and have higher availability. Moreover, obtaining cord blood is a much easier and gentler procedure than the stem cells used in bone marrow transplants.
Unlike the previous two patients, the woman did not experience graft-versus-host disease. Furthermore, she suffered very few side effects compared to the other cases. One of the patients, called ‘The Berlin Patient’ died after his transplant, while the other experienced weight loss and significant inner ear damage.
What makes the woman’s case more groundbreaking, is that along with being a woman she is of mixed race. People of color are often underrepresented in donor registries; moreover, previous HIV studies have always included white men. Thus, the woman’s chances of finding a donor with a genetic match and the mutation were very low.
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.
Dr Steven Deeks, an AIDS expert at the University of California, San Francisco
Source: UCLA
