A U.S. woman has become the third person, and the first woman in the world to be considered cured of HIV, thanks to a stem cell transplant from umbilical cord blood.
The woman, whom researchers described as middle-aged, was diagnosed with acute myeloid leukemia four years after her HIV diagnosis. Following the cancer diagnosis, her clinical course included first high-dose chemotherapy and then a stem cell transplant donated by a family member. Subsequently, the patient received an additional stem cell transplant from umbilical cord blood of an unrelated infant. The cord blood had a mutation that makes the cells resistant to HIV infection.
About three years after the 2017 transplant, the patient stopped taking antiretroviral therapy specifically for HIV infection, and at 14 months after stopping therapy, she had no detectable virus.
According to Dr. Marshall Glesby, associate chief of the Division of Infectious Diseases at Weill Cornell Medicine, the advantage of using umbilical cord blood is that it is taken from a national repository that allows scientists to identify blood with the HIV-resistant mutation.
Although the discovery may open a new avenue toward HIV treatment research, researchers warn that this type of therapy may not be extendable to the 37 million people living with HIV, most of whom live in sub-Saharan Africa. In fact, stem cell transplantation can have serious contraindications, side effects, and a fatality rate of up to 20 percent; therefore, it is not feasible to consider subjecting people who do not need it to transplantation.
The curative potential of stem cell transplants was demonstrated in 2007 when Timothy Ray Brown became the first person to be "cured" of HIV after undergoing a transplant from a donor who was naturally resistant to the virus. Since then, the feat has been repeated only twice with Adam Castillejo and now the New York patient. All three had HIV and an oncological disease that needed a stem cell transplant to save their lives. Curing HIV was never the primary goal for this therapeutic choice.
Importantly, to date, under conditions of high available resources, people with HIV on regular antiretroviral therapy and monitoring can have a normal quality and expectancy of life.
Source: CNN
