A woman known as the “New York patient” received a stem cell transplant to cure her HIVand now he has been virus-free and off HIV medication for about 30 months, the researchers reported.
“We’re calling this a potential cure rather than a definitive cure—basically, we’re waiting for a longer follow-up period.” Dr. Yvonne Bryson (opens in a new tab)director of the Los Angeles-Brazil AIDS Consortium at the University of California, Los Angeles and one of the doctors who oversaw the case, said at a news conference on Wednesday (March 15).
Only a handful of people have been cured of HIV, so there is currently no official distinction between being cured and being in long-term remission. Dr. Deborah Persaud (opens in a new tab), interim director of pediatric infectious diseases at the Johns Hopkins University School of Medicine, who also oversaw the case. Although the New York patient’s prognosis is very good, “I think we’re reluctant to say at this point whether he’s cured,” Persaud said at a news conference.
Bryson and his colleagues were released early data on the New York patient in February 2022 and released more details about the case in Thursday’s (March 16) paper Cell (opens in a new tab). The new report covers most of the patient’s case up to the point when he had stopped taking antiretroviral therapy (ART) – the standard treatment for HIV – for about 18 months.
Related: A British man becomes the second person cured of HIV after being virus-free for 30 months
The patient received a stem cell transplant in August 2017 and stopped ART after just over three years. Now he’s been off the meds for about 2.5 years and “is still doing very well and enjoying his life.” Dr. Jingmei Hsu (opens in a new tab)director of the Cell Therapy Laboratory at NYU Langone Health and one of the leaders of the transplant team, said at a news conference.
Previous cases of HIV cure – including final cures Men treated in LondonBerlin and Dusseldorf, and one case of prolonged remission A man treated in Los Angeles – had received bone marrow stem cell transplants as a dual treatment for both cancer and HIV. (The first patient cured of HIV, a man from Berlin, died in 2020 after a cancer relapse.)
All of these transplants used bone marrow stem cells from adult donors who had two copies of a rare genetic mutation: CCR5 delta 32. This mutation changes the doorway that HIV typically uses to enter white blood cells, thereby preventing the virus from entering. After the transplant, the donor’s stem cells take over the patient’s immune system and replace their old, HIV-sensitive cells with new, HIV-resistant cells. To make way for new immune cells, doctors wipe out the original immune cell population using chemotherapy or radiation therapy.
As in previous cases, the New York patient had both cancer and HIV and was undergoing chemotherapy before his transplant. However, he received cord blood stem cells that contained the HIV resistance genes. Umbilical cord blood was donated by the parents of the related infant at delivery and was later screened for the CCR5 delta 32 mutation.
To supplement the umbilical cord stem cells, since they were relatively few, the patient also received stem cells donated by a relative, which helped to bridge the gap when his HIV-resistant cells began to appear.
Because cord blood is easier to access than adult bone marrow and is easier to “match” between donors and recipients, such procedures may become more common in the future. However, stem cell transplants would not be suitable for patients who are HIV-positive but do not have another serious illness, such as cancer, because of the destruction of the immune system involved, Bryson said.