HIV Cured | Patient cured of HIV after stem cell transplant
A woman is HIV cured and leukemia cured after being treated with a new type of hematopoietic stem cell transplant. If her condition remains stable, she will be the third person cured of HIV thanks to a transplant, after patients in London and Berlin.
The Conference on Retroviruses and Opportunistic Infections (Croi) brings together the best specialists in the Human Immunodeficiency Virus (HIV) each year. This 2022 edition, still ongoing in San Francisco, was marked by the presentation of the case of an HIV patient in remission after receiving a transplant of two types of hematopoietic stem cells. An approach never tested before.
Two types of transplanted stem cells
The main objective of the transplant was not to cure the HIV infection, which she contracted in 2013, but the acute myeloid leukemia which declared itself a few years later, in 2017.
She was transplanted with two types of hematopoietic stem cells: cells from a compatible adult donor and cells taken from the blood contained in the umbilical cord.
However, the cord blood cells were carriers of the CCR5Δ32 mutation, naturally present in a handful of individuals who are, de facto, immunized against HIV. Indeed, the virus needs CCR5, or CXCR4, as a co-receptor when entering CD4 T cells.
“This study provides hope in the use of umbilical blood cells, or a combination of umbilical blood cells and haploidentical transplantation, to achieve HIV-1 remission in individuals who have required transplantation for other illnesses. It also provides evidence that viral reservoirs of HIV-1 can be cleared to enable remission and potentially cure,” said Yvonn Bryson, an HIV specialist at the University of California School of Medicine (UCLA).
A third case of HIV cured?
The procedure had already been attempted on two other patients, but the graft had failed. This time, the patient did not develop graft versus host disease and 100 days after the transplant, her condition is good and HIV is now undetectable. The patient stopped her antiretroviral treatment 14 months ago, without a resurgence of the virus. She is also considered in remission from her leukemia.
If her state of health remains constant, she will be the first patient cured of HIV thanks to a transplant of adult and umbilical stem cells. She is already nicknamed the patient of New York, in homage to the city where she was treated. The patients in Berlin and London were, for their part, only transplanted with adult stem cells, also carriers of the CCR5Δ32 mutation.
Photo description: scanning electromicrograph of an HIV-infected T cell.