In the Journals

Stem cell transplant may have cured HIV infection in Berlin patient

Allers K. Blood. 2010;10.1182/blood-2010-09-309591.

An HIV-infected patient may have been cured of HIV infection 3.5 years after receiving stem cell transplantation, according to researchers from Charité – University Medicine Berlin.

The researchers previously reported the likelihood of hematopoietic stem cell transplantation with CCR5D32/D32 donor cells in the HIV-infected patient with relapsed acute myeloid leukemia (AML) — missing viremia were documented within the first 20 months of remission. Yet, it was not certain whether or not the patient was cured of HIV infection.

For the current study, the researchers set out to examine whether CD4+ T cells were restored, whether or not the patient’s immune system had HIV-susceptible target cells, and to identify the size of the HIV-reservoir during immune reconstitution after transplantation.

The patient had a relapse of AML 13 months after initial transplant; he then underwent a second round of chemotherapy followed by another stem cell transplant from the original donor. ART was stopped at the time of the original stem cell transplant, according to the researchers.

Compared with 10 patients without HIV who underwent stem cell transplantation (controls), mucosal CD4+ T-cell count were normalized and HIV remained undetectable in the one patient previously infected with HIV. Further, the size of the potential HIV reservoir decreased during 3.5 years follow-up, according to the researchers.

“Our results show, that systemic recovery of CD4+ T cells following CCR5D32/D32 stem cell transplant and discontinuation of ART was not impaired when compared to that of stem cell transplant control patients,” the researchers wrote. “From these results, it is reasonable to conclude that cure of HIV infection has been achieved in this patient.”

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An HIV-infected patient may have been cured of HIV infection 3.5 years after receiving stem cell transplantation, according to researchers from Charité – University Medicine Berlin.

The researchers previously reported the likelihood of hematopoietic stem cell transplantation with CCR5D32/D32 donor cells in the HIV-infected patient with relapsed acute myeloid leukemia (AML) — missing viremia were documented within the first 20 months of remission. Yet, it was not certain whether or not the patient was cured of HIV infection.

For the current study, the researchers set out to examine whether CD4+ T cells were restored, whether or not the patient’s immune system had HIV-susceptible target cells, and to identify the size of the HIV-reservoir during immune reconstitution after transplantation.

The patient had a relapse of AML 13 months after initial transplant; he then underwent a second round of chemotherapy followed by another stem cell transplant from the original donor. ART was stopped at the time of the original stem cell transplant, according to the researchers.

Compared with 10 patients without HIV who underwent stem cell transplantation (controls), mucosal CD4+ T-cell count were normalized and HIV remained undetectable in the one patient previously infected with HIV. Further, the size of the potential HIV reservoir decreased during 3.5 years follow-up, according to the researchers.

“Our results show, that systemic recovery of CD4+ T cells following CCR5D32/D32 stem cell transplant and discontinuation of ART was not impaired when compared to that of stem cell transplant control patients,” the researchers wrote. “From these results, it is reasonable to conclude that cure of HIV infection has been achieved in this patient.”

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