Research Highlights: Stem Cell Transplant Leads to HIV Remission
- HIV remains incurable.
- Only one case is reported that HIV has been cured.
- A patient underwent stem-cell transplant using a donor with a mutation in the CCR5 gene.
- CCR5 is a receptor protein that HIV use to infect a cell.
- Supposedly, the stem-cell transplant was performed to treat the patient’s leukemia.
- The stem-cell transplant was performed together with radiotherapy.
- It was unclear which therapy contributed to the long-term HIV remission.
- In this study, researchers show that HIV remission may be possible with a less aggressive and toxic approach.
- An adult underwent stem-cell transplant for Hodgkin’s lymphoma.
- Hodgkin’s lymphoma is a cancer of the blood that originates in the lymphatic system.
- After the transplant, the patient experienced mild gut graft-versus-host disease.
- Graft-versus-host disease occurs when the immune cells of the donor’s tissue attack the host’s cells.
- Antiviral therapy was discontinued 16 months after the stem-cell transplant.
- HIV remission was maintained over a further 18 months.
- HIV traces in the plasma has been undetectable.
- HIV traces in white blood cells also has been undetectable.
- A test shows no signs of reactivatable virus.
- Before the transplant, CCR5-tropic viruses were identified from white blood cells.
- White blood cells isolated from peripheral blood after the stem-cell transplant did not express CCR5 and were vulnerable only to CXCR4-tropic virus.
- HIV T cell immune responses disappeared after the transplant.
- Cytomegalovirus-specific responses remained detectable.
- Cytomegalovirus is a common virus that can retain in the body for life.
- Additionally, HIV-specific antibodies decreased after the transplant.
- Researchers were unable to conclude that the patient has been cured.
- However, the results suggest that stem-cell transplant with CCR5 mutation may be sufficient to achieve HIV remission.
- The findings provide more support for the development of HIV remission techniques based on CCR5 repression.
Gupta, R.K., Abdul-Jawad, S., McCoy, L.E. et al. HIV-1 remission following CCR5Δ32/Δ32 haematopoietic stem-cell transplantation. Nature 568, 244–248 (2019). https://doi.org/10.1038/s41586-019-1027-4