“Umbilical cord blood” transplant cures mixed-race woman’s HIV

Pic Credit: Thomas Deerinck, NCMIR/Science Source/New York Times

By Aaron Humes: The New York Times reports scientists on Tuesday announced the apparent cure of a mixed-race woman of human immunodeficiency virus (HIV), the virus that causes AIDS, by a new transplant method involving umbilical cord blood.

Cord blood is more widely available than the adult stem cells used in the bone marrow transplants that cured two previous patients, and it does not need to be matched as closely to the recipient. Most donors in registries are of Caucasian origin, so allowing for only a partial match has the potential to cure dozens of Americans who have both HIV and cancer each year, scientists said.

The woman, who also had leukemia, received cord blood to treat her cancer. It came from a partially matched donor, instead of the typical practice of finding a bone marrow donor of similar race and ethnicity to the patient’s. She also received blood from a close relative to give her body temporary immune defenses while the transplant took.

Researchers presented some of the details of the new case on Tuesday at the Conference on Retroviruses and Opportunistic Infections in Denver, Colorado.

The sex and racial background of the new case mark a significant step forward in developing a cure for HIV, the researchers said.

Infection with HIV is thought to progress differently in women than in men, but while women account for more than half of HIV cases in the world, they make up only 11 percent of participants in cure trials.

Powerful antiretroviral drugs can control HIV, but a cure is key to ending the decades-old pandemic. Worldwide, nearly 38 million people are living with HIV, and about 73 percent of them are receiving treatment.

A bone marrow transplant is not a realistic option for most patients. Such transplants are highly invasive and risky, so they are generally offered only to people with cancer who have exhausted all other options.

There have only been two known cases of an HIV cure so far. Referred to as “The Berlin Patient,” Timothy Ray Brown stayed virus-free for 12 years, until he died in 2020 of cancer. In 2019, another patient, later identified as Adam Castillejo, was reported to be cured of HIV, confirming that Brown’s case was not a fluke.

Both men received bone marrow transplants from donors who carried a mutation that blocks HIV infection. The mutation has been identified in only about 20,000 donors, most of whom are of Northern European descent.

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