An American research team reported that it may have cured HIV in a woman for the first time. Building on previous successes and failures in the field of HIV cure research, these scientists used a state-of-the-art stem cell transplant method that they hope will expand the pool of people who could receive similar treatment to several dozens a year.
Your patient has joined an exclusive club that includes three men who have been cured, or most likely cured, of HIV by scientists. The researchers also know of two women whose own immune systems appear to have uniquely defeated the virus.
Carl Dieffenbach, director of the Division of AIDS at the National Institutes of Allergy and Infectious Diseases, one of several divisions of the National Institutes of Health funding the research network behind the new case study, told NBC News that the accumulation of Repeated apparent triumphs have been in the Cure for HIV 'continues to offer hope'.
"It is important that there continue to be successes in this direction," he said.
In the first case of a successful HIV cure, researchers treated American Timothy Ray Brown for acute myeloid leukemia, AML for short. He received a stem cell transplant from a donor who had a rare genetic abnormality that gives immune cells targeted by HIV a natural resistance to the virus. The strategy in Brown's case, first published in 2008, has apparently cured HIV in two more people. But it has also failed in several others.
This therapeutic process is designed to replace one person's immune system with another person's, treating their cancer while curing their HIV. First, doctors must destroy the original immune system with chemotherapy and sometimes radiation. The hope is that this will also destroy as many immune cells as possible that secretly harbor HIV despite effective antiretroviral treatment. As long as the transplanted HIV-resistant stem cells implant correctly, the new copies of the virus that arise from the remaining infected cells cannot infect other immune cells.
Experts stress that it is unethical to attempt an HIV cure through stem cell transplantation, a toxic, sometimes fatal procedure, on someone who does not have a life-threatening cancer or other condition that already makes them a risky candidate for the treatment. treatment.
Dr Deborah Persaud, pediatric infectious disease specialist at Johns Hopkins University School of Medicine, who chairs the NIH-funded scientific committee behind the new case study (International Clinical Trials Network on Adolescent Maternal Pediatric AIDS), said, "While we're at it, we're very excited" about this new case of a possible HIV cure, the stem cell treatment method "is still not a viable strategy for all but a handful of millions of people who living with HIV.
Breaking new ground in HIV cure science
Dr. Yvonne J. Bryson, a specialist in pediatric infectious diseases at the David Geffen School of Medicine at UCLA, described the new case study Tuesday at the annual virtual conference on retroviruses and opportunistic infections.
The "New York patient," as the woman is known because she received her treatment at New York-Presbyterian Weill Cornell Medical Center in New York City, was diagnosed with HIV in 2013 and leukemia in 2017.
Bryson and Persaud joined a network of other investigators to conduct laboratory tests to evaluate the woman. At Weill Cornell, Drs. Jingmei Hsu and Dr. Koen van Besien of the stem cell transplant program with infectious disease specialist Dr. Marshall Glesby teamed up for patient care.
This team has long sought to alleviate the considerable challenge researchers face in finding a donor whose stem cells can treat a patient's cancer and cure her HIV.
Traditionally, such a donor must have a close enough human leukocyte antigen, or HLA, match to maximize the chance that the stem cell transplant will be successful. The donor must also have the rare genetic abnormality that confers resistance to HIV.
This genetic abnormality occurs at a rate of only about 1 percent, primarily in people of Northern European descent and even in people native to this area.