A woman appears to have been cured of HIV after receiving a transplant of stem cells from umbilical cord blood, scientists announced Thursday, joining only a handful of people cured from the virus following a novel procedure that increases the odds of making a cure available to a more racially diverse group of people than would be possible using other treatments.
A middle-aged, mixed-race woman—called the “New York patient” to protect privacy—appears to have been cured from HIV after receiving a stem cell transplant to treat leukemia, researchers wrote in a medical case report published in Cell.
The patient, who has been living without HIV since 2017 and is no longer taking drugs to suppress the virus, could be the first woman to be cured of the virus, though the researchers conservatively describe her case as one of long-term remission.
Just three people have been confirmed clear of HIV—another in long-term remission is expected to join this group—all of whom beat the virus after receiving bone marrow transplants from donors naturally resistant to HIV.
As the mutation conferring HIV resistance is rare—though less so among white people—and stem cell donors must be carefully matched to patients, including by race and ethnicity, researchers said it is very difficult finding suitable, HIV-resistant donors for patients of color.
Stem cells from umbilical cord blood are both more readily available and do not need to be matched as closely as adult cells do, which “broadens the opportunities” for people of all racial backgrounds living with HIV to be cured, said study coleader Yvonne Bryson, a professor of pediatrics at UCLA.
Though certainly a game changer for people who need a transplant already, the researchers stressed that stem cell transplants are not a realistic cure for HIV on their own given the procedure’s risky, highly invasive nature and brutal side effects.
Barring the unique circumstances of a very small number of people, there is no cure for HIV. Historically, an HIV diagnosis was a death sentence, but today those living with the virus can expect to live long, healthy lives on par with their HIV-negative peers if they receive prompt treatment with antiviral drugs. Such treatment, inevitably lifelong, can reduce the virus to undetectable levels in the body, keeping it in check and preventing it from being passed on to others. These drugs can also prevent infection if taken by someone without HIV—a technique called PrEP (pre-exposure prophylaxis)—which has been hailed as a major public health breakthrough in efforts to combat the virus. Unfortunately, drugs used to treat or prevent HIV are often beyond the reach of many people in poorer countries who are at risk of infection or living with the virus, and it is still a major contributor to death and disease worldwide.
Experts are working hard to develop ways of curing, treating and preventing HIV infection, but it is a uniquely challenging virus to fight. Its biology means scientists have to approach it differently than other pathogens like measles, polio and influenza. It mutates rapidly, can hide from the immune system and sets up viral reservoirs during the earliest stages of infection that can activate years later, all of which complicate efforts to treat or prevent infection. The virus also targets the immune cells normally responsible for fighting invaders, weakening and destroying immune defenses over time, which can progress to Acquired Immune Deficiency Syndrome, or AIDS. Additionally, and unlike many other viruses, HIV is not naturally cleared by the body once established, meaning any vaccine must meet a higher bar of preventing it from gaining a foothold in the body.
WHAT TO WATCH FOR
Scientists have been trying to create an HIV vaccine for decades. Efforts have not panned out so far, most recently when a promising candidate failed in late-stage clinical trials this year. One candidate tested in the 2000s even appeared to increase the risk of contracting the virus. Despite the setbacks, experts are still trying to develop one and are pushing ahead with new approaches, such as using the mRNA technology behind Moderna and Pfizer’s successful Covid vaccines.
40.1 million. That’s how many people have died from AIDS-related illnesses since the start of the HIV epidemic, according to UNAIDS. According to the World Health Organization, some 38.4 million people were living with the virus in 2021. An estimated 1.5 million people acquired HIV that year and some 650,000 people died from AIDS-related illnesses, the agency said.
By Robert Hart, Forbes Staff