A woman of mixed race appears is cured of HIV, using a new transplant method involving umbilical cord blood. She is the third person ever to be cured of the disease.
According to the scientists, the umbilical cord blood method opens up the possibilities of curing more people of diverse racial backgrounds than it was previously possible.
The previous two patients were cured by the adult stem cells used in the bone marrow transplants. However, as cord blood are widely available, and it does not need to be matched as closely to the recipient, it is being considered as more prominent solution.
As per the sources, most donors in registries are of Caucasian origin. This allows a partial match and the potential to cure dozens of Americans who have both HIV and cancer each year.
The woman also had leukemia, and received cord blood to treat her cancer. It came from a partially matched donor, instead of the typical practice of finding a bone marrow donor of similar race and ethnicity to the patient’s. In addition to that, she also received blood from a close relative, which gave her body temporary immune defences while the transplant was in action.
The researcher’s study shows that the sex and racial background of the new case mark a significant step forward in developing a cure for HIV.
Dr. Steven Deeks, an AIDS expert at the University of California, San Francisco who was not involved in the work said that the fact that the patient was a mixed race and belonged to a female gender group was really important scientifically and in terms of the community impact.
Infection with HIV is known to progress differently in women than in men. Although the percentage of women affected by HIV is more in comparison to men all around the world, they make up only 11% of participants in cure trials.
Scientists believe that although powerful antiretroviral drugs can control HIV, but a cure is key to ending the decades-old pandemic. Nearly 38 million people from around the world are suffering from HIV and about 73% of them are receiving treatment. However, a bone marrow transplant cannot be a realistic option for most patients, as such exercises are highly invasive and risky. That is why, these are only offered to people with cancer and have exhausted all other options.
Only two men with HIV have been cured before this, and both of them received bone marrow transplants from donors who carried a mutation that blocks HIV infection. Such mutation has been identified in only about 20,000 donors, most of whom are of Northern European descent.
In the previous treatments, bone marrow transplants were used to replace all of the patient’s immune system. The experiment wasn’t quite promising, as both the men suffered punishing side effects including graft versus host disease (a condition in which the donor’s cells attack the recipient’s body). One of the patient almost died after the transplant and another’s treatment was less intense. However, year after his transplant, the latter lost nearly 70 pounds of weight. Apart from that, he developed a hearing loss and survived multiple infections, according to his doctors.
In comparison to them, the woman in the latest case left the hospital by day 17 after her transplant and did not develop any side effects, said Dr. JingMei Hsu, the patient’s physician at Weill Cornell Medicine.
According to her doctor, the transplant from the relative is like a bridge that got her through to the point of the cord blood being able to take over.
The now patient refused to continue the antiretroviral therapy 37 months after the transplant. It has been more than 14 months now, and she shows no sign of HIV in her blood tests, also she does not seem to have detectable antibodies to the virus.
It is yet to be discovered why stem cells from cord blood seem to work so well, but one possibility is that they are more capable of adapting to a new environment. Dr. Koen Van Besien, director of the transplant service at Weill Cornell claimed the report and said, “These are newborns; they are more adaptable.”
Cord blood may also contain elements beyond the stem cells that aid in the transplant.
Steven Deeks said in a statement that Umbilical stem cells are attractive but there’s something magical about these cells and something magical perhaps about the cord blood in general that provides an extra benefit.