The case of a middle-aged woman of mixed race, presented at the
Conference on Retroviruses and Opportunisitic Infections in Denver,
is also the first involving umbilical cord blood, a newer approach
that may make the treatment available to more people.
Since receiving the cord blood to treat her acute myeloid leukemia -
a cancer that starts in blood-forming cells in the bone marrow - the
woman has been in remission and free of the virus for 14 months,
without the need for potent HIV treatments known as antiretroviral
therapy.
The two prior cases occurred in males - one white and one Latino -
who had received adult stem cells, which are more frequently used in
bone marrow transplants.
"This is now the third report of a cure in this setting, and the
first in a woman living with HIV," Sharon Lewin, President-Elect of
the International AIDS Society, said in a statement.
The case is part of a larger U.S.-backed study led by Dr. Yvonne
Bryson of the University of California Los Angeles (UCLA), and Dr.
Deborah Persaud of Johns Hopkins University in Baltimore. It aims to
follow 25 people with HIV who undergo a transplant with stem cells
taken from umbilical cord blood for the treatment of cancer and
other serious conditions.
Patients in the trial first undergo chemotherapy to kill off the
cancerous immune cells. Doctors then transplant stem cells from
individuals with a specific genetic mutation in which they lack
receptors used by the virus to infect cells.
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Scientists believe these individuals then
develop an immune system resistant to HIV.
Lewin said bone marrow transplants are not a viable strategy to cure
most people living with HIV. 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," she said.
The study suggests that an important element to the success is the
transplantation of HIV-resistant cells. Previously, scientists
believed that a common stem cell transplant side effect called
graft-versus-host disease, in which the donor immune system attacks
the recipient’s immune system, played a role in a possible cure.
"Taken together, these three cases of a cure post stem cell
transplant all help in teasing out the various components of the
transplant that were absolutely key to a cure," Lewin said.
(Reporting by Julie Steenhuysen; Editing by Bill Berkrot and David
Gregorio)
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