Sarah Jacoby contributed to this article.
Having followed an experimental stem cell transplant
procedure, a woman has gone 14 months with no detectable levels of HIV in her
body. The "New York patient," as she's been dubbed, is the fourth
person — and the first woman — to be cured of HIV through this method. hiv test kit at-home blood testing
According to the National Institute of Allergy and
Infectious Diseases, she is one of 25 HIV-positive people who received a cord
blood stem cell transplant to treat cancer or other underlying conditions as
part of the IMPAACT P1107 clinical trial, which began in 2015.
According to the National Institute of Allergy and
Infectious Diseases, the New York patient was diagnosed with acute myeloid
leukemia four years into her HIV treatment. Her cancer went into remission
following chemotherapy. In 2017, she underwent the procedure. She stopped
taking antiretroviral medication around three years after the transplant. For
14 months, she has been HIV-free.
According to Dr. John Torres, NBC's senior medical
correspondent, the New York patient is "functionally" cured because,
while doctors haven't been able to detect HIV in her blood for several months,
it will take even longer to be sure she is truly cured. "The virus can be
tricky to deal with. It's capable of hiding and reappearing a decade later, so
they're keeping a close eye on it "he stated
She is the most recent of a small number of HIV-positive
patients who have reportedly been cured after receiving a stem cell transplant.
The first patient dubbed the "Berlin patient," was HIV-free for 12
years before succumbing to leukemia in 2020. Researchers presented the cases of
the "London patient" and the "Düsseldorf patient" in 2019,
who both achieved HIV remission after stem cell transplantation.
However, the case of the New York patient is unique. In
general, the procedure entails first administering chemotherapy to the
patients' bodies in order to eliminate cancerous cells. Then, stem cells with a
specific genetic mutation are transplanted into them. According to Torres, the
goal is to treat both cancer (and another underlying health condition) and HIV
by essentially destroying and replacing the patient's immune system.
A haplo-cord transplant was performed on the New York
patient, which is a hybrid of two transplants: Then there was the umbilical
cord blood transplant, which contained the HIV-resistant genetic mutation.
After that, she received an adult stem cell transplant. According to NBC News,
the technique, developed by a team at Weill-Cornell Medicine, has some
advantages over previous methods, including a lower risk of graft vs. host
disease.
"These procedures have a lot of potential side effects,
including death," Bruce Walker, director of the Ragon Institute at MGH,
MIT, and Harvard, told TODAY. As a result, it's only used in patients who
already have another potentially fatal condition. "Without that, it's
difficult to recommend that someone undergo a potentially lethal procedure at
exorbitant costs," Walker, who studies the immune response to viral
infections, particularly HIV, said.
While the new case is promising, stem cell transplants are
"still not a feasible strategy for all but a handful of the millions of
people living with HIV," according to Dr. Deborah Persaud, scientific
chair of the committee overseeing the International Maternal, Pediatric Adolescent
AIDS Clinical Trials and a pediatric infectious disease specialist at Johns
Hopkins University School of Medicine.
There were also two documented cases of women — known as
elite controllers — whose immune systems were able to eradicate the virus on their
own. "Based on these two cases, (there maybe) a way to augment the body's
immune system to be able to do a better job eliminating the virus,"
Walker, whose Ragon Institute led the research on these two cases, said.
"It's possible, based on these unusual cases. It's up to us now to figure
out how to do it again."
Despite the fact that there is no universal cure for HIV,
patients can receive antiretroviral therapy. According to the Centers for
Disease Control and Prevention, people can effectively manage HIV and even get
it to undetectable levels in the blood with this type of ongoing treatment.
According to the CDC, at that point, a patient has "effectively no
risk" of transmitting the virus to others via sex.
According to Walker, learning more about these rare
successful cases of HIV cure will hopefully aid researchers in finding better
ways to treat more people living with the disease. "Cases like these
demonstrate what's possible," he said. "It also helps to focus us on
the steps we need to take to make this more accessible to a wider
audience."
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