Stem cell transplantation achieved temporary HIV remission

From Family Practice News, 21 July 2014:

Allogeneic hematopoietic stem cell transplantation from HIV-naive individuals to HIV-1–positive individuals may achieve temporary antiretroviral-free remission of infection and loss of detectable HIV-1, a study showed.

Two men with chronic HIV-1 infection received allogeneic hematopoietic stem cell transplants (HSCTs) from susceptible donors to treat Hodgkin’s and non-Hodgkin’s lymphoma, and achieved temporary remission of HIV despite stopping antiretroviral therapy (ART), with the virus undetectable in both blood and rectal mucosa.

However, both experienced viral rebound – one at 12 weeks after stopping ART and one at 32 weeks – with both developing the usual symptoms of acute retroviral syndrome, according to a paper published online July 22 in the Annals of Internal Medicine.

“In summary, our results suggest that allogeneic HSCT with CCR5 wild-type donor cells may lead to loss of detectable HIV-1 from blood and rectal mucosa, but viral rebound may nevertheless occur after ART interruption despite a significant reduction in reservoir size,” wrote Dr. Timothy J. Henrich of Brigham and Women’s Hospital, Boston, and his colleagues.

The researchers had previously reported the reduction in peripheral blood HIV-1 reservoirs in these two patients (Ann. Intern. Med. 2014 July 22 [doi:10.7326/M14-1027]).

“However, extensive sampling of tissues and large numbers of peripheral blood mononuclear cells for the presence of HIV-1 is necessary to understand the full effect of allogeneic HSCT on HIV-1 persistence,” they wrote, arguing that treatment interruption was also necessary to establish if the virus was in remission. Read more.

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