Third person cured of HIV | A step towards total recovery

After male patients – in Berlin in 2008 and London in 2020 – the first woman appears to have been cured of HIV, scientists announced in February. A breakthrough that could stimulate research towards a potential treatment for the disease, at a time when an increase in HIV infections is being felt in Canada.

Alice Girard-Bosse
The Press

A drastic increase

In recent years, Canada has seen a sharp rise in cases of the human immunodeficiency virus (HIV), which causes AIDS. “We have suffered drastic increases since 2014, with an increase of around 25%. With the pandemic, unequal access to screening in the country has also manifested itself in an increase in STBBIs,” maintains Mr. Lacasse.

A chronic illness

The treatments offered to date usually consist of a combination of three antiretroviral drugs taken daily. These drugs do not eradicate the virus, but reduce the viral load in the patient. “It works extremely well, and people have a life expectancy that’s about the same as people who don’t have HIV, but it’s still a chronic disease,” says Dr.^r Michel Alary, population health researcher at the CHU de Québec–Université Laval.

An effective transplant

On February 15, scientists announced that a woman of mixed racial origin appears to have been cured of HIV. The patient, who underwent a transplant as part of treatment for leukemia, received stem cells from a newborn baby with a rare genetic mutation that prevents HIV from taking hold. Three months after the transplant, all of the woman’s blood cells were now resistant to HIV. She was able to stop taking her antiretroviral drugs.

Two other cases

This is not the first time that a stem cell transplant has cured an individual with HIV. Two other cases of recovery have been reported worldwide so far. Known as the “Berlin patient” and the “London patient”, the two men received stem cell transplants from bone marrow. Their donors were also carriers of the mutation that makes them resistant to infection.

More diversity

The fact that this third patient, nicknamed the patient from New York, is a mixed-race woman is a great scientific advance, experts believe. Indeed, the mutation being much more common in people of European descent, it is more difficult to find donors for stem cell transplants in non-white patients.

The use of umbilical cord blood, as in the cured patient, does not require finding a donor of similar ethnicity, unlike bone marrow transplants which made it possible to cure the two previous patients, indicates Éric Cohen, professor of virology at the Faculty of Medicine of the University of Montreal. The use of umbilical cord blood therefore opens the way to the healing of more people of various origins.

For better representation

The patient is also the first woman to be diagnosed with long-term remission. “This is important and it sends a very good message, considering that only around 11% of participants in clinical trials for cures are women. It is important that there is a good representation, even almost equal, to ensure that the treatments are generalizable”, maintains Mr. Cohen.

A risky procedure

Could stem cell transplantation by immunized donors be generalizable to all patients? No, say the experts without hesitation. The transplant is a very risky procedure, with a mortality rate of 10% to 20%, says the D^r Alary. It is therefore only considered in people with HIV who also have cancers and other diseases.

The future

Experts hope that this breakthrough will lead to a cure for the disease. “We would like to mimic this approach, without the risks it may entail. I am very confident that we will get there, ”says Professor Cohen. Until then, the D^r Alary recalls the importance of good screening and generalized access to treatment.