HIV+ Woman in Remission after Stem Cell Transplantation
On February 15, 2022, researchers at UCLA presented at CROI 2022 (the Conference on Retroviruses and Opportunistic Infections) the first case of a woman whose HIV is in remission after she received a new combination of specialized stem cell transplants for treatment of acute myeloid leukemia (AML).
The patient, a mixed-race American woman who was diagnosed with acute HIV in 2013 and high-risk AML in 2017, received a transplant of cord blood cells having the HIV-protective CCR5-delta32/32 mutation and with adult stem cells from a related donor. She has been in remission of AML for four and a half years and has had no HIV rebound in the fourteen months since antiretroviral therapy was stopped.
If her HIV remission continues and she is determined to be cured, she would be only the third person to achieve cure and the first HIV remission to have been successfully engrafted with umbilical cord blood cells with CCR5-delta32/32 homozygous combined with stem cells from an adult, haploidentical (“half-matched”) related donor. The two previous patients with HIV cure received adult donor cells, one from bone marrow and one from blood stem cells that had the protective mutation, but no umbilical cord blood cells.
Researchers pointed out that although stem cell transplantation is not a therapy for HIV, its effects in patients living with HIV and undergoing therapy for blood or lymph cancers provide researchers with insights and potential targets in HIV treatment. “This study provides hope for the use of cord blood cells or a combination of cord blood cells and haploidentical (half-matched) grafts to achieve HIV-1 remission for individuals requiring transplantation for other diseases. It also provides proof that HIV-1 viral ‘reservoirs’ can be cleared sufficiently to afford remission and possibly cure in the setting of resistant target cells,” said Bryson, the protocol chair for the International Maternal Pediatric Adolescent AIDS Clinical Trials Network (IMPAACT), the organization conducting the observational IMPAACT P1107 study.
For more information about the IMPAACT study, log on to: https://bit.ly/3sLCTg5.