Third patient with HIV cured after receiving stem cell transplant

US researchers help a woman who received a stem cell transplant to treat acute myeloid leukemia achieve remission of HIV. As Medical Writing explains , it is the third documented case of disappearance of the human immunodeficiency virus after receiving a stem cell transplant.

In the last 14 months the patient has not needed antiretroviral therapy and shows no trace of HIV in the blood or antibodies against the virus

Known as the "New York patient", it is the first case in which stem cells come from umbilical cord blood. Both of the above cases occurred in men who had received adult stem cells, most often used in bone marrow transplants.

According to scientists, with umbilical cord blood, the same level of compatibility between donor and recipient is not needed. This, according to the researchers, may make this type of treatment benefit more people.

The cases of Berlin and London

Before the "New York patient" we knew the cases of the patient from Berlin and the one from London. Timothy Brown was the first person in the world to be 'cured' of HIV after undergoing a stem cell transplant in 2008 to overcome acute myeloid leukemia (AML). He is the “Berlin patient”.

Eleven years later, in 2019, the "London patient" became the second case after the virus remained 'undetectable' 29 months after the interruption of antiretroviral treatment (ART). As explained by the Medical Gazette , this patient received a stem cell transplant in 2016 to treat Hodgkin's lymphoma.

no side effects

The difference between these three cases is that both men suffered serious side effects, including graft-versus-host disease.

In contrast, the woman left the hospital on the 17th day after her transplant.

She did not develop graft-versus-host disease, JingMei Hsu, the patient's doctor, told The New York Times .

According to Hsu, the combination of the umbilical cord blood and his patient's cells could have spared him many of the serious side effects of a bone marrow transplant.

antiretrovirals vs. mother cells

Antiretroviral treatment is essential to keep HIV infection under control. It prevents the virus from multiplying, reduces its concentration in the body and the risk of transmission. This effect disappears within weeks of stopping treatment.

For their part, the stem cells these patients received came from donors who had two copies of a mutation that makes white blood cells resistant to HIV. As the donor's cells replace the person's cells with the virus, the chances of HIV replicating decrease. And, therefore, the chances that it can continue to infect. And in the end, as it has been in these three patients, the virus ends up disappearing.

spacious studio

The case of the "New York patient" was presented at the Conference on Retroviruses and Opportunistic Infections. It is part of a larger study by the University of California at Los Angeles (UCLA) and Johns Hopkins University in Baltimore.

Its goal is to follow 25 people with HIV who are undergoing an umbilical cord blood stem cell transplant for the treatment of cancer and other serious illnesses.

The American researchers suggest that this third case of HIV remission makes umbilical cord stem cell transplantation to be considered as a method to achieve remission and cure for people living with this disease and who require such a transplant for other pathologies.

The “New York Patient” is a woman of mixed race, something researchers attach great importance to. The genetic mutation that makes someone resistant to the virus usually occurs in white people. This has made it difficult until now to find compatible donors for people of other races. The stem cell donor was naturally resistant to the virus that causes AIDS, according to the researchers.