Scientists: Woman is 3rd to be cured of HIV

A middle-aged, mixed-race woman is the third patient to be potentially cured of HIV, with the virus in long-term remission four years after she received a transplant of stem cells harvested from an infant's umbilical cord blood.

The new case, reported Tuesday at the annual meeting of the Conference on Retroviruses and Opportunistic Infection, is the first time the transplant approach has been successfully reported in a mixed-race woman, an advance that reinforces the exciting concept that an HIV cure may be possible in a wider array of people by using cord blood.

In 2009, scientists first reported that a white man with leukemia, originally known to the world only as the “Berlin patient,” had been possibly cured of HIV with a transplant of stem cells resistant to HIV.

A decade later, the approach was used in the “London patient,” a Hispanic man with Hodgkin's lymphoma.

One-off reports of long-term HIV remission have inspired hope and reignited the search for an HIV cure, but they also come with inherent limitations.

All of the patients, including the middle-aged woman, who was treated by doctors at Weill Cornell Medicine in New York, received the transplant as part of treatment for cancer.

The “Berlin patient,” later revealed to be Timothy Ray Brown, eventually died — when his leukemia, not his HIV, rebounded.

Stem cell transplants are not likely to be widely used as a treatment for otherwise healthy people living with HIV.

“This is critical science to eventually get us to a cure,” said Carlos del Rio, professor of medicine at Emory University School of Medicine. “This is not a scalable intervention. The way I think about this: This is like sending someone on a rocket to the moon. It's great science, but it's not the way we're going to travel.”

The patient, who has not been publicly identified, was diagnosed with HIV in 2013.

Four years later, she developed high-risk acute myeloid leukemia and received the stem cell transplant as a treatment for both diseases. The transplanted stem cells were different from those used in previous cases. Those cases depended on stem cells from adults, and they are harder to match with a recipient.

The woman received a “haplo/ cord transplant” that included a mixture of stem cells from a relative and stem cells from an infant's umbilical cord. The infant stem cells contained a naturally occurring, but rare, feature that made them resistant to HIV. They possessed a deletion in the CCR5 gene that made it impossible for the virus to infect cells. That deletion usually occurs in people of Northern European or Caucasian descent.

The patient stopped taking the antiretroviral drugs that kept her HIV in check 14 months ago, and there has been no rebound of the virus.

The level of virus in her blood was “undetectable through this whole period,” said Yvonne J. Bryson, an infectious-diseases physician at the David Geffen School of Medicine at the University of California at Los Angeles, who presented the case.

“This provides hope for the use of cord blood cells ... to achieve HIV remission for individuals requiring transplant for other diseases,” Bryson said. “This provides additional proof that HIV reservoirs can be cleared sufficiently to afford remission and cure.”