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US doctors announce the first cure of a woman with HIV

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US doctors announce the first cure of a woman with HIV

A stem cell transplant to treat leukemia eliminates the AIDS virus from a patient

A team of US doctors has announced the possible cure of the first woman with HIV thanks to an umbilical cord blood transplant. The patient received treatment to try to end leukemia that she suffered from. The intervention against this blood cancer seems to have swept the virus from her body, as her doctors announced today at a conference on retroviruses held in Denver (USA) and The New York Times has advanced.

This case joins two other patients “in remission” – the researchers are reluctant to talk of a cure. The first was the so-called Berlin patient, Timothy Brown, who spent 12 years HIV-free after a stem cell transplant – eventually dying in 2019 from cancer. The second, also a man was announced in 2019. An international consortium in which the IrsiCaixa research center in Barcelona participated identified another patient who, after a stem cell transplant, stopped taking antiretrovirals and has been without detectable HIV for 3 and a half years.

In the woman’s case, doctors withdrew conventional antiviral treatment 37 months after transplant. One year and two months later, he shows no trace of HIV in his blood and no antibodies against the virus.

The most striking thing about this remission is that the patient, whose age and name have not been published, received a different transplant from the two previous cases. Both men underwent bone marrow transplantation from fully matched adult donors with their immunological profiles. In both cases, the donors had a mutation in the CCR5 gene. that confers resistance to HIV infection. Blood stem cells from the donor’s bone marrow eventually replace those of the patient, shrinking their blood tumor and giving them resistance to HIV. The third patient, on the other hand, received umbilical cord blood from a donor who also had the beneficial mutation. The mechanics of stem cell replacement is the same, but in this case, the compatibility with the donor was lower.

This type of intervention can take months to take effect, so doctors also resorted to a transfusion of blood stem cells taken from a close relative of the patient to improve the chances of success. This probably strengthened the patient’s immune system until the umbilical cord blood transplant took effect, which in turn reduced the risk of the intervention, according to Marshall Glesby, a physician at Cornell University in New York and a member from the medical team to the American newspaper. The two previous cases suffered important complications after the transplant, but this woman was able to leave the hospital 17 days after the intervention.

This milestone is also important because it is a woman. Some studies have detected a different progression of the infection in men than in women, but despite this, women are a minority in clinical trials of new treatments against this infection.

José Alcamí, director of the AIDS Immunopathology Unit of the National Microbiology Center of the Carlos III Health Institute, explains the importance of this new case. “Umbilical cord cells that are removed after birth and stored frozen in biobanks have been used here,” he says. “In bone marrow transplants, the donors are adults and therefore there must be full compatibility between donor and recipient. If we add to that the need to have the mutation in the CCR5 gene, we have that compatibility only happens in one case out of six million. With umbilical cord blood, on the other hand, compatibility can be less than 50%, which increases the chances of finding a suitable donor”, ​​he details.

In any case, it will be difficult to extend the scope of this treatment to many infected with HIV, since it is only ethical to apply this type of transplant to people suffering from hematological cancers, such as leukemia, warns Alcamí. “We have to remember that the mortality associated with this type of transplant is 30%, so it should only be applied to people with hematological tumors. Another thing is that the cord samples with the mutation in the CCR5 gene be reserved in the case in the future it can be used for another patient who also has HIV. This is a very spectacular case, but punctual”, he highlights.

About Siya

Siya
Siya has a master’s degree in Marketing and editor with passion. He holds 7 years’ experience in this field. She holds a keen interest in the know-how of what is brewing in healthcare and science.

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