- An HIV-positive woman who received a blood stem cell transplant to treat acute myeloid leukemia appears to have been cured of HIV.
- The stem cells, from umbilical cord blood, contained a gene variant that makes them resistant to HIV infection.
- The woman has been free of HIV for 14 months since the treatment.
- This finding could point toward a cure for HIV for some patients.
A middle-aged, mixed-race, HIV-positive woman has been free of the virus since receiving a blood stem cell transplant for a different condition.
Following high-dose chemotherapy for acute myeloid leukemia — a treatment that destroys blood cells — the woman received the stem cell transplant from specialists at Weill Cornell Medicine, in New York City.
They used transplant cells from two sources: stem cells from a healthy adult relative and umbilical cord blood from an unrelated newborn.
Doctors use umbilical cord blood to supply blood stem cells when a good match cannot be found. Cord stem cells are often successful, even when their immune markers only partially match the recipient’s.
The stem cells from the adult donor are used to rapidly restore the patient’s blood cell population. The cord stem cells replicate to replenish the blood cells in the longer term.
For this transplant, the doctors used umbilical blood stem cells containing a gene variant that gives resistance to HIV. The CCR5 gene encodes a cell receptor used by the HIV virus to enter the cells, but the CCR5Δ32 variant blocks the entry of the virus.
Three months after the treatment, the doctors found that all the patient’s blood cells derived from the HIV-resistant cord blood stem cells. The team detected no HIV when performing highly sensitive assays of the patient’s blood.
The patient then stopped taking antiretroviral drugs to suppress her HIV infection.
Now, 14 months after the treatment, the HIV infection has not reemerged. The patient has also been leukemia-free for 4 years.
“This is a very interesting case that could help inform our understanding and approach to HIV cure research.”
– Dr. Michael Brady, medical director of the Terrence Higgins Trust, speaking to Medical News Today.
Doctors have reportedly cured HIV in two men, and this is the first such report in a woman.
It is also the first time a person who identifies as mixed race has received the treatment, as the CCR5Δ32 variant is much more common in people of European heritage.
The specialists treating the leukemia were the first to use cord blood cells in this way. Using cord blood, doctors can give cells with the CCR5Δ32 variant to people of non-European heritage, for whom finding well-matched CCR5Δ32 donors would be difficult.
“It’s important to note that a stem cell transplant, which was used to treat leukemia in this case, is a very risky procedure and not one which could be scaled up to ‘cure’ the millions of people living with HIV across the globe,” Dr. Brady cautioned.
Although the woman has no signs of HIV, the specialists stress that they regard her as being in long-term remission, rather than cured.
They, too, note that this treatment carries significant risks, and doctors can only consider it for HIV-positive people with cancer who need blood stem cell transplants.
While welcoming the findings, Dr. Brady emphasized that finding a cure was only one element of the fight against HIV:
“A cure for HIV would be amazing. Whilst research into that continues, we mustn’t forget that we already have highly effective HIV treatments that both protect the immune system from damage — meaning people living with HIV can expect long and healthy lives — and fully suppress the virus so it can’t be passed on to their partners.”
– Dr. Brady
“It’s these facts that are turning the tide against the epidemic and tackling HIV-related stigma.”