First Woman In World Believed To Be Cured Of HIV After Stem Cell Transplant: Report

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First Woman In World Believed To Be Cured Of HIV After Stem Cell Transplant: Report

This is the first case that involves umbilical cord blood, a newer approach that could make the treatment available to more individuals. However, researchers said that the method is too risky to be suitable for most people diagnosed with HIV.

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A U.S. patient with leukaemia is believed to be the first woman and the third individual in the world to be cured of HIV. The patient received a stem cell transplant from a donor with natural resistance to the virus that causes AIDS.

Presented at the Conference on Retroviruses and Opportunistic Infections in Denver on February 15, the case of a middle-aged woman of mixed race is also the first that involves umbilical cord blood, a newer approach that could make the treatment available to more individuals. However, researchers said that the method is too risky to be suitable for most people diagnosed with HIV.

Ever since receiving the cord blood to treat her acute myeloid leukaemia - cancer that starts in blood-forming cells in the bone marrow - the patient has been in remission and free of the virus for 14 months, without any need to take the antiretroviral therapy used as a cure for HIV, Reuters reported.

The two prior cases occurred in males who had received the same type of adult stem cells, which are often used in bone marrow transplants.

"This is now the third report of a cure in this setting, and the first in a woman living with HIV," Sharon Lewin, President-Elect of the International AIDS Society, said in a statement.

The case is part of a more extensive U.S. backed study led by Dr Yvonne Bryson of the University of California Los Angeles (UCLA), and Dr Deborah Persaud of Johns Hopkins University in Baltimore. It aims to follow 25 individuals living with HIV who had received the stem cells taken from umbilical cord blood to treat cancer and other severe diseases. The transplanted cells that were selected have a specific genetic mutation and cannot be infected by HIV.

According to researchers, patients in the trial first undergo chemotherapy to kill the cancerous immune cells. Doctors then transplant stem cells from patients with a specific genetic mutation lacking receptors used by the virus to infect cells.

Scientists believe the immune system of recipients can develop resistance to HIV.

Lewin said that bone marrow transplants are not feasible to cure most patients living with HIV. However, the report "confirms that a cure for the disease is possible and further strengthens using gene therapy as a viable strategy for HIV cure," she said.

The study suggests that an essential element to the success is the transplantation of HIV-resistant cells. Earlier, scientists believed that a common stem cell transplant side effect called graft-versus-host disease, in which the donor's immune system attacks the recipient's immune system played a crucial role in a possible cure.

"Taken together, these three cases of a cure post stem cell transplant help in teasing out the different components of the transplant that were key to a cure," Lewin said.

The findings around this most recent case study are yet to be published in a peer-reviewed journal, so more comprehensive scientific understanding is still limited.

What Makes HIV Difficult To Cure?

When the highly effective combination antiretroviral treatment for HIV started in the year 1996, Dr David Ho, one of the architects of this therapeutic revolution and director of the Aaron Diamond AIDS Research Center in New York City, famously theorised that given enough time, such medications could eventually eradicate the virus from the human body.

To date, there are a handful of cases of individuals who were started on antiretrovirals immediately after contracting HIV. After the patients went off treatment, they have remained in viral remission with no rebounding virus for years, according to NBC News.

Otherwise, Ho's prediction has proved false. During the past quarter-century, HIV-cure researchers have learned in increasingly exacting detail what a daunting task it is not only to cure a disease but to develop effective curative therapies that are safe and scalable.

HIV maintains a permanent presence in the human body because shortly after an infection, the virus binds its genetic code into long-lived immune cells that will enter a resting state. Antiretrovirals only work on replicating cells, so HIV can remain under the radar of such medications in resting cells for long periods, sometimes even years. Absent any HIV treatment, such cells could restart their engines at any time and repopulate the body with huge amounts of virus.

Published in 2009, Timothy Brown's case ignited the HIV-cure research field, which has seen rising financial investment.

In 2019, researchers pointed out two new cases of HIV remission following treatments that mirrored what Brown received. These included London citizen Adam Castillejo, who had Hodgkin lymphoma, and a man from Düsseldorf, Germany, who had Acute Myeloid Leukemia.

Over three years have passed since these two patients have been on HIV treatment with no viral relapse. Consequently, the authors of each of their case studies recently said that their respective patient was "almost definitely" cured of the disease.

Since 2020, experts have also announced the cases of two women whose own immune systems have cured them of HIV. They are among approximately one in 200 individuals with HIV known as "elite controllers," whose immune systems can significantly suppress viral replication without any medicine. Their bodies went even further and destroyed all available viruses in these cases.

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