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Woman reported hiv stem cell transplant12/24/2023 ![]() ![]() By a year after the transplant, she no longer had antibodies against HIV, which suggests HIV was no longer replicating in her body. After transplant, no HIV DNA or RNA were detected. ![]() Before the transplant, she controlled her HIV infection with antiretroviral drugs, but some HIV genetic material was still detectable. The patient’s leukemia remains in remission more than five years after the transplant. But cord blood cells are less likely to do so and, in this case, the patient did not develop graft-versus-host disease. A major risk associated with stem cell transplants is graft-versus-host disease-when transplanted immune cells attack the recipient’s body. But by 14 weeks after transplant, the cord blood cells had completely taken over. Results appeared in Cell on March 16, 2023.Īs expected, the relative’s stem cells engrafted quickly, within two weeks of transplant. This allows them to provide some immune function until the cord blood cells have a chance to take over. In this type of transplant, the adult stem cells engraft quickly, but temporarily. These did not carry the CCR5 Δ32 mutation but were partially compatible with the patient. So, the researchers infused the cord blood cells alongside stem cells from a relative of the patient. A challenge with transplanting cord blood stem cells is that it takes time for the cells to engraft in the body. The researchers obtained cord blood stem cells with two CCR5 Δ32 mutations that were a partial match for the patient. If successful, this approach could expand the pool of CCR5 Δ32 stem cells available to those living with HIV. Umbilical cord blood stem cells don’t need as close a match for successful transplant as adult stem cells. Because of the difficulty in finding a compatible adult donor, the transplant included stem cells from banked umbilical cord blood. Their patient was a middle-aged woman who self-identified as mixed-race and had both HIV and fast-progressing, or acute, leukemia. ![]() Jingmei Hsu at Weill Cornell Medicine, Yvonne Bryson of the University of California, Los Angeles, and Deborah Persaud of the Johns Hopkins University School of Medicine used a modified approach to try to cure HIV. But very few people carry two copies of CCR5 Δ32, limiting the chances of finding a compatible donor, particularly for non-White patients.Ī team led by Drs. CCR5 is a receptor that HIV uses to infect cells. The stem cell donors all carried two copies of a mutation, CCR5 Δ32, that confers resistance to HIV. The men received transplants of stem cells from adult donors to treat their cancers. All three involved men with HIV and either leukemia or lymphoma. Three cases of HIV being cured have been reported to date. The treatment combination of chemotherapy-to kill the cancerous immune cells-with stem cell transplantation is thought to have allowed the development of an HIV-resistant immune system.įunded by the NIH, this study is conducted by the International Maternal Pediatric Adolescent AIDS Clinical Trial Network (IMPAACT) and is part of ongoing efforts to better understand and treat HIV.HIV (yellow) attacks the immune system by destroying CD4+ T cells (red), a type of white blood cell that is vital to fighting off infection. Unlike previous cases that involved bone marrow transplants, which can lead to complications, cord blood stem cells appear to be more efficacious. The transplanted stem cells have a genetic mutation that prevents them from expressing the receptor that HIV uses to latch onto cells, thus rendering them resistant to HIV. Since transplantation, the woman has ceased ART and shows no detectable levels of HIV. She then received transplantation of HIV-resistant cord blood stem cells alongside adult donor stem cells from a relative. After chemotherapy for leukemia, she achieved cancer remission and her HIV levels were controlled but detectable. In the case presented at CROI, the woman had been on antiretroviral therapy (ART) for HIV infection for four years when she was diagnosed with acute myeloid leukemia. As per a recent media advisory from the National Institutes of Health (NIH), this is the third known case of HIV remission following stem cell transplantation that was presented at the 2022 Conference on Retroviruses and Opportunistic Infections (CROI). ![]() A woman with mixed race ancestry has been HIV-free for the past 14 months after receiving cord blood stem cell transplant treatment in 2017. ![]()
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