The first “mixed-race” woman “cured” of HIV

Doctors report that a woman known as the “New York patient” who received a stem cell transplant to treat HIV is now free of the virus and stopped taking AIDS treatment 30 months ago.

Doctors said that treatment by transplanting HIV-resistant stem cells from umbilical cord blood had yielded successful long-term results.
This approach has been used successfully to treat a “New York patient,” a middle-aged woman with leukemia and HIV who identifies as “mixed race” and has been infected with HIV since 2017.

“We call this a potential cure, not a cure,” Dr. Yvonne Bryson, director of the Los Angeles-Brazil AIDS Consortium at UCLA and one of the doctors who led the case, told a press conference on Wednesday, March 15. “We’re basically waiting for a longer follow-up period.” .

Only a small number of people are cured of HIV, so at this point, there is no official distinction between treatment and long-term recovery, said Dr. Deborah Persaud, interim director of pediatric infectious diseases at Johns Hopkins University School of Medicine. Although the New York patient’s prognosis is very good, I think we are reluctant to say at this point whether she has fully recovered.”

Bryson and her colleagues released early data on the New York patient in February 2022 and published more details about the case Thursday, March 16, in a case report in the journal Cell.

HIV, Leukemia Patient from New York Becomes the First Mixed-Race Woman to Possibly Cured – Tech Times https://t.co/NPUK3YDyoR

— Stem cell Watch (@StemcellWatch) March 17, 2023

The new report covers the patient’s case from inception to the point she stopped taking antiretroviral therapy (ART), the standard treatment for HIV.

The patient received a stem cell transplant in August 2017 and stopped taking antiretroviral therapy after just over three years.

A middle-aged, mixed-race woman—called the “New York patient” to protect privacy—appears to have been cured of #HIV after receiving a stem cell transplant to treat leukemia.
#Forbes

🔗 https://t.co/rEwo4irjCU pic.twitter.com/mUNqK2oEG1

— Forbes Middle East (@Forbes_MENA_) March 16, 2023

The use of stem cells from umbilical cord blood instead of the bone marrow from matched adults could, as has been done previously, increase the possibility of treating HIV in patients of all ethnic backgrounds.

To be clear, only about 1% of white people have the same CCR5-delta32 mutation, which is rare in other populations.
This rarity limits the possibility of transplanting stem cells that carry the beneficial mutation into patients of color because stem cell transplants usually require a strong matching between donor and recipient.

Since finding an adult donor compatible with the New York patient’s mutation was nearly impossible, the team instead transplanted stem cells carrying the CCR5-delta32/32 mutation from stored umbilical cord blood donated by the parents of an unrelated child at birth, to try to treat both cancer and HIV. human immunity simultaneously.

Cord blood cells were injected along with stem cells from a relative of the patient to increase the chance of success.

The transplant successfully cured both the patient’s HIV and leukemia, and that recovery has now lasted more than four years. Thirty-seven months after the transplant, the patient was able to stop taking her anti-HIV medication.

Doctors who continue to monitor her say she has tested negative for HIV for more than 30 months since stopping antiretroviral therapy (at the time the study was written, it had been just 18 months).
Previous HIV treatment cases, including definitive cures for men treated in London, Berlin and Dusseldorf, and one case of long-term recovery for a man treated in Los Angeles, received bone marrow stem cell transplants as a dual treatment for both cancer and HIV. HIV. (The first cured HIV patient, a man from Berlin, died in 2020 after his cancer relapsed.)

All of these transplants used bone marrow stem cells from adult donors who carried two copies of the rare CCR5 delta 32 gene mutation.

This mutation changes the entrance that HIV normally uses to enter white blood cells, thus preventing the virus from entering.

After transplantation, the donated stem cells essentially take over the patient’s immune system, replacing old HIV-exposed cells with new, HIV-resistant cells.

To clear the way for new immune cells, doctors destroy the original population of immune cells using chemotherapy or radiation therapy.

Because cord blood is easier to access than adult bone marrow and easier to “match” between donors and recipients, such procedures may become more common in the future. However, stem cell transplants would not be suitable for patients who have HIV but do not have a second serious disease, such as cancer, because it involves wiping out the immune system, according to Bryson.