Recent research from Johns Hopkins University highlights a landmark case: the first hybrid woman to receive a cord blood transplant from a donor with the CCR5-Δ32 mutation has remained in HIV remission for more than four years. The findings are detailed in a leading scientific journal.
Historical milestones in HIV cure research include the so‑called Berlin Patient, who began HIV remission in 2009. Since then, two other men known as the London Patient and the Düsseldorf Patient have achieved viral clearance. All three received stem cell transplants as part of cancer treatment, and the transplanted cells carried two copies of the CCR5-Δ32 mutation which blocks HIV from entering immune cells.
Cord blood is rich in stem cells, including hematopoietic stem cells that give rise to blood and immune cells. Cord blood transplantation offers an alternative to bone marrow transplantation and shares the same basic purpose of rebuilding a patient’s blood and immune system. In the past, some HIV-positive patients have received stem cells from adult donors for these procedures.
In a newer study, scientists used stem cells derived from umbilical cord blood. A New York City patient diagnosed with acute myeloid leukemia and HIV received an HIV-resistant stem cell transplant from cord blood in addition to an adult donor. The approach aimed to address both the blood cancer and the HIV infection.
Prior to the transplant, the patient’s immune system was weakened by chemotherapy, a common step to prepare the body for donor cells. Stem cell transplants are generally reserved for HIV patients who require the procedure for an accompanying condition such as blood cancer rather than for HIV treatment alone.
The procedure succeeded, and the patient has remained free from both HIV and leukemia for more than four years. Antiretroviral therapy was discontinued about 37 months after the transplant, marking a notable milestone in HIV management for this patient.
Only a small fraction of the population carries one copy of the CCR5-Δ32 mutation, with higher prevalence among individuals of European descent. The rarity of this mutation in other populations presents a challenge for matching donors who carry the mutation. In this study, donor availability was estimated to be substantially lower for non-European populations compared with European patients, underscoring the need for broader donor searches and diverse donor registries to improve odds of finding compatible CCR5-Δ32 carriers for more patients.