Research Highlights: Stem Cell Transplant Leads to HIV Remission

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Stem Cell Transplant
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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.[3]
  • 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.[1]
  • 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.[2]
  • 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.

Source:

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

[1] https://www.medicinenet.com/graft_versus_host_disease_gvhd/article.htm

[2] https://www.mayoclinic.org/diseases-conditions/cmv/symptoms-causes/syc-20355358

[3] Hodgkin’s Disease: Symptoms, Diagnosis, and Treatment (healthline.com)

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