• Friday, March 29, 2024
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Scientists cure woman of HIV, cancer in novel treatment

Scientists cure woman of HIV, cancer in novel treatment

Scientists have cured a woman of mixed race of HIV using a new transplant method involving umbilical cord blood that opens up the possibility of curing more people of diverse racial backgrounds than was previously possible, scientists announced on Tuesday in New York.

She becomes the third person to have been cured of the malignant disease.

Cord blood is more widely available than the adult stem cells used in the bone marrow transplants that cured the previous two patients, and it does not need to be matched as closely to the recipient.

Most donors in registries are of Caucasian origin, so allowing for only a partial match has the potential to cure dozens of Americans who have both HIV and cancer each year, scientists said, according to a New York Times report.

The woman, who also had leukemia, 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.

She also received blood from a close relative to give her body temporary immune defenses while the transplant took.

Researchers presented some of the details of the new case on Tuesday at the Conference on Retroviruses and Opportunistic Infections in Denver, Colo.

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The sex and racial background of the new case mark a significant step forward in developing a cure for HIV, the researchers said.

“The fact that she’s mixed race, and that she’s a woman, that is really important scientifically and really important in terms of the community impact,” Steven Deeks, an AIDS expert at the University of California, San Francisco who was not involved in the work said.

Infection with HIV is thought to progress differently in women than in men, but while women account for more than half of H.I.V cases in the world, they make up only 11 percent of participants in cure trials.

But Deeks, a doctor, said he did not see the new approach becoming commonplace. “These are stories of providing inspiration to the field and perhaps the road map,” he said.

Powerful antiretroviral drugs can control H.I.V., but a cure is key to ending the decades-old pandemic. Worldwide, nearly 38 million people are living with H.I.V., and about 73 percent of them are receiving treatment.

A bone marrow transplant is not a realistic option for most patients. Such transplants are highly invasive and risky, so they are generally offered only to people with cancer who have exhausted all other options.

There have only been two known cases of an H.I.V. cure so far. Referred to as “The Berlin Patient,” Timothy Ray Brown stayed virus-free for 12 years, until he died in 2020 of cancer.

In 2019, another patient, later identified as Adam Castillejo, was reported to be cured of H.I.V., confirming that Mr. Brown’s case was not a fluke.

Both men received bone marrow transplants from donors who carried a mutation that blocks H.I.V. infection. The mutation has been identified in only about 20,000 donors, most of whom are of Northern European descent.

In the previous cases, as the bone marrow transplants replaced all of their immune systems, both men suffered punishing side effects, including graft versus host disease, a condition in which the donor’s cells attack the recipient’s body. Mr. Brown nearly died after his transplant. Mr. Castillejo’s treatment was less intense, but in the year after his transplant, he lost nearly 70 pounds, developed a hearing loss and survived multiple infections, according to his doctors.

By contrast, the woman in the latest case left the hospital by day 17 after her transplant and did not develop graft versus host disease, said JingMei Hsu, the patient’s physician at Weill Cornell Medicine.

The combination of cord blood and her relative’s cells might have spared her much of the brutal side effects of a typical bone marrow transplant, Hsu said.

“It was previously thought that graft versus host disease might be an important reason for an H.I.V. cure in the prior cases,” said Sharon Lewin, president-elect of the International AIDS Society, who was not involved in the work. The new results dispel that idea, Lewin said.