Researchers report third case of HIV remission - first woman - after umbilical-cord blood transplant

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  • A woman was cured of HIV after receiving a stem cell transplant with a rare genetic mutation that blocks HIV infection.
  • The patient had no detectable virus and stopped antiretroviral treatment following the transplant.
  • While the case is promising, scientists say this won't be an option for everyone living with HIV.

After nearly four decades, researchers remain hopeful that they will find a cure for HIV. To date, only a handful of patients have been lucky enough to defy all odds to overcome the virus.

One of these patients is a US woman, dubbed the "New York patient". She recently became the third known person to have benefitted from a unique treatment for blood cancer – a stem cell transplant using umbilical cord blood.

Her case was reported this month by researchers working as part of the International Maternal Pediatric Adolescent AIDS Clinical Trials Network (IMPAACT). 

According to the team, the middle-aged patient has been virus-free for more than four years after receiving the treatment. 

She was diagnosed with HIV a decade ago and, in 2017, tests confirmed she had acute myelogenous leukaemia (AML), a cancer of the blood and bone marrow. It can be life-threatening if left untreated.

“This third case, reported from IMPAACT P1107 in a woman of mixed race, suggests that … cord stem cell transplantation should be considered to achieve HIV remission for people living with HIV who require such a transplant for another illness,” they said.

Receiving cells resistant to infection

The patient received blood stem cells from a relative to replenish the blood cell levels she lost through intensive chemotherapy. 

She then went on to receive stem cells – through umbilical cord blood – from an unrelated newborn. About one month later, she slowly started generating white blood cells. 

However, quite remarkably, the cord blood had a genetic mutation, known as the CCR5 delta-32 mutation, that makes cells resistant to HIV infection.

What happened next

Around three years after her transplant, the woman stopped taking HIV antiretroviral therapy (ART), and, just over one year later, had no detectable signs of the virus. She has also been in remission for cancer for over four years.

“Based on these results, the participant has been deemed in HIV remission,” the researchers said.

However, researchers of the study cautioned that this scientific and medical development does not apply to everyone living with HIV.

Only around 50 people a year with HIV and blood cancer may benefit from this approach, Dr Yvonne Bryson, chief of paediatric infectious diseases at the David Geffen School of Medicine at UCLA and principal investigator of the study, told CNN.

Dr Anthony Fauci, director of the National Institute on Allergy and Infectious Diseases, also  said in an interview on the "Conversations on Health Care" radio show: "This person happened to have an underlying disease which required a stem cell transplant so I don't want people to think that now this is something that can be applied to the 36 million people who are living with HIV.”

Fauci said that it was not practical to think that this approach was something that would be widely available.

But the report "confirms that a cure for HIV is possible and further strengthens using gene therapy as a viable strategy for an HIV cure", Sharon Lewin, President-Elect of the International AIDS Society, said in a statement.

The other two known cases

The mutation involved in the above stem cell transplant case has previously been observed in two other cases, also leading to HIV remission.

One is Timothy Ray Brown, dubbed the "Berlin patient", who was in remission for more than a decade. He passed away in 2020 as a result of cancer. The other is the "London patient" who has been HIV-free for more than two years.

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READ | Second man seems to be free of HIV after stem cell transplant

READ | The London patient: "A critical moment in the search for an HIV cure."

READ | New HIV variant found in the Netherlands – progresses to Aids faster, but responsive to treatment

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