The woman, called the “New York patient,” was diagnosed with HIV in 2013 and with acute myeloid leukemia, an aggressive cancer of the blood and bone marrow, in 2017. She received umbilical cord blood to treat her leukemia that came from a donor who was a partial match, a departure from standard practice that uses a donor of the same racial and ethnic mix. Her cancer has been in remission for 4.5 years, and her HIV has been in remission over the 14 months since she stopped treating the virus with antiviral therapy.
‘Cured’ if Remission Lasts at Least 30 Months
“For a cure, we are still at the early days,” says Carl Dieffenbach, PhD, director of the division of AIDS at the National Institute of Allergy and Infectious Diseases, which funded the research leading to this patient’s treatment. Scientists will consider her HIV cured if she remains in remission with the virus at undetectable levels in her blood for at least 30 months, Dr. Dieffenbach adds. Yvonne Bryson, MD, a professor and HIV specialist at the David Geffen School of Medicine at the University of California in Los Angeles, who led the research study involving the New York patient, presented details of the case at the 2022 Conference on Retroviruses and Opportunistic Infections (CROI). The first man, known as the “Berlin patient,” lived with HIV in remission for 12 years before dying of cancer. The second man, known as the “London patient,” had been in remission for more than 30 months, according to a statement from the National Institutes of Health (NIH). Most cord blood donors are white, as are many patients who participate in medical research. It’s encouraging that the New York patient was able to receive a cord blood from a partially matched donor instead of one of similar race and ethnicity, because this may encourage more people of diverse backgrounds to become donors or join clinical trials, Dieffenbach says. “This approach opens up options for more diverse populations,” Dr. Bryson said during her presentation at CROI. Worldwide, almost 38 million people are living with HIV, and roughly 1 in 4 of them receive antiviral treatment, according to UNAIDS. Almost one million people worldwide at high risk for HIV — including injection drug users and men who have sex with men — take a treatment regimen known as preexposure prophylaxis (PrEP) to minimize their risk of developing HIV. A widely available HIV cure involving stem-cell transplants like the treatment used for the New York patient is a long way off, Dieffenbach says. But there is still a lot people can do to prevent HIV and to remain healthy if they’re living with the virus. PrEP is 99 percent effective at preventing sexually transmitted HIV, and 74 percent effective at preventing HIV among people who inject drugs, according to the Centers for Disease Control and Prevention (CDC). Individuals living with HIV who take antivirals and keep the virus at undetectable levels also can’t transmit the virus to a sexual partner, a prevention approach summed up as by the NIH as “Undetectable=Untransmittable (U=U).” “Right now, U=U really is a cornerstone of stopping HIV,” Dieffenbach says.
