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The third person ever to be cured of HIV with medical treatment was the first female patient and the first to receive a transplant using umbilical cord blood, and her recovery suggests the possibility that it can help more patients of all races, according to recent reports.
The patient’s continued health nearly four years after the procedure was described at the Feb. 15 Conference on Retroviruses and Opportunistic Infections in Denver. The patient received a transplant of “cord blood” from a donor who had a mutation in their CCR5 gene that makes them resistant to HIV infection, said the original report on the procedure by doctors from Weill Cornell Medicine, New York.
The woman, who had been on a standard antiretroviral treatment to control her HIV, was chosen for this risky transplant procedure after she developed acute myeloid leukemia, a cancer of the blood and bone marrow, the original study explained. She recovered well and was able to leave the hospital just over two weeks after her transplant, the study said.
The woman, who had the transplant in August 2017, was able to stop taking her HIV medication in 2020, hasn’t shown any detectable traces of the infection, and her cancer is in remission, The Wall Street Journal reported.
She also apparently had an easier recovery than the two previous patients deemed to have been cured of HIV. The previous cases used bone marrow transplants to replace the entire immune systems, and both patients “suffered punishing side effects, including graft versus host disease, a condition in which the donor’s cells attack the recipient’s body,” The New York Times reported.
Benefits of cord blood transplant
Unlike the previously used allogenic bone marrow transplant, the “cord blood” transplant that this latest patient received does not necessitate that the donor and recipient share the same genetic type, according to Johns Hopkins. This made it easier to find a donor for the patient, who is of mixed race, said The New York Times. The majority of bone marrow donors are white, and their recipients generally have to be white too, The New York Times said.
Although the treatment is not indicated for most HIV patients, “we estimate that there are approximately 50 patients per year in the US who could benefit from this procedure,” Dr. Koen van Besien, one of the doctors involved in the treatment, was quoted as saying in The Guardian.
In general, the supply of cord blood exceeds that of donated marrow, and cord blood cells are easier to store, according to an article in Frontiers in Medicine. “Among many sources of hematopoietic stem cell sources, cord blood (CB) is the one that belongs to the earliest stages of life. Thus, CB has many features resembling fetal or even embryonic stem cells,” the article said.
“Umbilical stem cells are attractive,” Dr. Steven Deeks, an AIDS expert at the University of California told The New York Times. “There’s something magical about these cells and something magical perhaps about the cord blood in general that provides an extra benefit.”
