Third Person Living With HIV Has Been Cured by Transplant

February 15, 2022 – Woman has been in remission from HIV for 14 months after being treated for leukemia with adult stem cell and cord blood transplants. If she stops treatment without the slightest hint of HIV, she will become only the third person in the world and the first woman to be cured by a transplant.

“Her own virus couldn’t infect her cells,” said Yvonne Bryson, MD, chief of pediatric infectious diseases at UCLA School of Medicine, who presented the study at a conference on infectious diseases.

This approach can be made available to a wider range of people living with HIV. A biracial New York woman who requested that her race and age be kept secret to protect her privacy was diagnosed with HIV in 2013. She started treatment immediately and quickly developed an undetectable viral load, which not only prevents her from passing HIV to others but also gives the virus less time to enter cells where it can hide.

But in 2017, she was diagnosed with leukemia. As a last resort to cure her of her cancer, she received a combination of adult stem cells from a relative’s blood and cord blood obtained from a cord blood bank. This cord blood sample was chosen because it contained a genetic mutation that makes the immune system resistant to HIV.

Two previous HIV treatments, Timothy Ray Brown of Berlin and Adam Castillejo of London, also used stem cell transplants with the same mutation. But they had a bone marrow transplant. These transplants are more complex than cord blood transplants, which are commonly used to treat cancer in children.

In this case, her physicians used both.

“This allows adult cells to accelerate and grow until cord blood takes over,” said Bryson, who presented the data at the 2022 conference on retroviruses and opportunistic infections. Bryson shared data that showed that shortly after being diagnosed and treated for HIV, the patient’s viral load dropped to undetectable levels. When she got the transplant, she had a surge of the virus, but then it became undetectable again and has remained that way ever since. Her immune system rebuilt itself using new, HIV-resistant cells from the transplant. The transplant went so well that she was able to leave the hospital early.

One hundred days after the transplant, the immune system contained in the umbilical cord blood took over. After 27 months, she decided to stop all HIV treatment to see if the transplant worked.

It was a real test. But even as Bryson and his colleagues continued to monitor her closely, they found no signs of illness. She tested negative for HIV.

“Her cells are now resistant to HIV – both her own strains and lab strains,” Bryson said in an interview. “It has been 14 months since then. It has no rebound, no detectable virus.”

Most of the donors with the gene mutation this patient received are white, Bryson said, suggesting that this cross-racial approach could widen the pool of people living with HIV and cancer who are good candidates for it.

Now the challenge is to move from one case to making the drug available to other people with HIV.

For people living with HIV, especially women of color, the results raise hopes and questions. Nina Martinez knows a thing or two about how to be first.” In 2019, she became the first American woman of color living with HIV to donate a kidney to another person living with the virus. For her, the excitement of the first woman of color to be cured of HIV simply sheds light on how very white and male the HIV cure research has been so far.

“As for me, I’m not looking for a cure in which a successful step forward is getting cancer,” she said. “I’m looking at what will be sustainable? I want to know what works for a group of people.”Gina Marie Brown, a social worker living with HIV in New Orleans, also thinks about groups of people.

“Every time we make a breakthrough, it seems like the sun is coming out a little more from behind the clouds,” she said.

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