Story: Doctors "Cure" HIV Patient with Cord Blood Transplant

November 2014

Examples of media coverage:

Primer Paciente “Curado” del VIH por un Trasplante de Sangre de Cordón Umbilical – El Mundo, November 6, 2014
Doctors “Cure” HIV Patient with Blood Transplant – Local: Spain’s News in English, November 6, 2014
HIV Cure News 2014: Barcelona Doctors Believe They’ve Found Cure to AIDS-Causing Virus – Latin Post, November 8, 2014
Spain to Research HIV Cure Using Umbilical Cord Blood – El País, November 10, 2014
HIV Breakthrough! Spain Finds Functional Cure For HIV Virus (Confirmed) – In South Africa Today, July 13, 2015

Original sources:

Press release: La ONT y la SEHH Apuestan por el Trasplante de Sangre de Cordón Umbilical para Erradicar el VIH en Pacientes con Cáncer Hematológico – Ministerio de Sanidad, Servicios Sociales e Igualdad, La Organización Nacional de Trasplantes y la Sociedad Española de Hematología y Hemoterapia, November 6, 2014
Presentation by Rafael F. Duarte at a symposium titled Trasplante de Progenitores Hematopoyéticos Alogénico y Curación de VIH – LVI Congreso Nacional de la Sociedad Española de Hematología y Hemoterapia, November 7, 2014
Abstract by Rafael F. Duarte, et al. (Embargoed until December 10, 2014): Allogeneic Transplantation with CCR5Δ32/Δ32 Cord Blood Hematopoietic Cells in a HIV-Infected Patient– 56th American Society of Hematology Annual Meeting and Exposition, San Francisco, CA, December 6–9, 2014

TAG’s commentary:
The initial trigger for this story, which first appeared in the Spanish newspaper El Mundo, was a press release issued on November 6 by the National Transplant Organization, the Spanish Hematology and Hemotherapy Society, and the Ministry of Health. The primary focus of the release was the launch of a new research project that aims to provide cord blood stem cells from donors heterozygous for the CCR5Δ32 mutation to HIV-positive people who require stem cell transplants to treat cancers. The hope is that this approach can both treat the cancer and recapitulate the cure of HIV achieved in Timothy Brown (the only individual considered cured of HIV infection to date). But the release also mentions that the approach “succeeded in an HIV patient with lymphoma treated in 2013.” It is the reference to this previously unknown case that has become the focus of news reporting, and unfortunately misinformation has seeped into some of the articles.

The individual, who was treated in Barcelona, survived for only three months after the transplantation procedure due to a recurrence of the lymphoma (a Latin Post article misreports the posttransplant survival as three years). According to one of the researchers involved, HIV became undetectable in blood samples (by multiple tests), but antiretroviral therapy was not stopped and it was never proved that the individual was cured. The El Mundo article states that tissues and cerebrospinal fluid were also analyzed, but this appears to be an error. The potentially encouraging finding for the future is that the cord blood stem cell transplant with the CCR5Δ32 mutation did eventually engraft, although it required an additional cord blood stem cell transplant from a normal donor to assist the process. As with Timothy Brown, the individual was found to have developed an immune system resistant to CCR5-tropic HIV strains as a result of the engraftment of the transplant. The researchers note that a potential advantage of cord blood stem cells is that less stringent genetic matching of donor and recipient is required compared with adult stem cells (Brown’s procedure involved the latter).

A manuscript about the case has been submitted for publication, so more details will be forthcoming (May 2015 update: the case report is now published in The Lancet HIV). The lead researcher, Rafael Duarte, is due to present at the upcoming 56th American Society of Hematology Annual Meeting and Exposition, and his abstract is available online; however, it is under embargo until after the conference ends.

The media stories that have followed the initial El Mundo report offer examples of how misleading hype can be generated. The Latin Post article is headlined is “Barcelona Doctors Believe They’ve Found Cure to AIDS-Causing Virus,” and it opens with this stark sentence: “Spanish doctors in Barcelona believe they’ve found the cure to HIV.” The fact that the procedure itself is associated with a 15–25 percent risk of mortality is never mentioned, and its limitation to people with life-threatening cancers is referenced only in the last paragraph of the piece. Even then it states that the procedure is “primarily designed to assist HIV patients suffering from cancer,” when the reality is that it can only be tried in individuals requiring stem cell transplants for cancers. A subsequent piece in El País does far better and contains a clear and accurate description of the research project, although it also contains a quote from Duarte that HIV was “eliminated” from the individual in Barcelona and the evidence does not appear sufficient to support this claim.

Update July 27, 2015: Strangely, the inaccurate and misleading Latino Post story has suddenly reappeared in mid-2015 on Africa-based news sites, in a slightly altered form with an even more horrendously false headline: “HIV Breakthrough! Spain Finds Functional Cure For HIV Virus (Confirmed).” As far as I can tell this version first appeared on the site News 24 Zimbabwe on June 24, but has more recently been added to In South Africa Today. Unfortunately, these inaccurate articles are now being widely circulated on social media.

As mentioned in a prior posting, there are two research projects ongoing in the U.S. that are seeking to identify donors homozygous for the CCR5Δ32 mutation for HIV-positive people requiring stem cell transplants for cancers. One is for individuals 15 years or older and involves adult stem cells; the other is for both children and adults and will employ cord blood stem cells.

The company StemCyte has for some time been developing a bank of cord blood stem cells from donors homozygous for the CCR5Δ32 mutation and can make them available in individual cases (it supplied the cells for the man in Barcelona). Last year it provided cells for an HIV-positive boy with cancer in Minnesota, but he died due to graft-versus-host disease shortly after the transplant.

Lawrence Petz, the Medical Director of StemCyte, describes the company’s work in a recently published open-access review:

Cure of HIV-Infected Leukemia Patients with Cord Blood Transplantation – J Leuk 2014, 2:3