학술논문
HIV-1 remission and possible cure in a woman after haplo-cord blood transplant
Document Type
article
Author
Hsu, Jingmei; Van Besien, Koen; Glesby, Marshall J; Pahwa, Savita; Coletti, Anne; Warshaw, Meredith G; Petz, Larry; Moore, Theodore B; Chen, Ya Hui; Pallikkuth, Suresh; Dhummakupt, Adit; Cortado, Ruth; Golner, Amanda; Bone, Frederic; Baldo, Maria; Riches, Marcie; Mellors, John W; Tobin, Nicole H; Browning, Renee; Persaud, Deborah; Bryson, Yvonne; Team, the International Maternal Pediatric Adolescent AIDS Clinical Trials Network P1107; Anthony, Patricia; Hazra, Rohan; Mitsuyasu, Ronald; Pahwe, Savita; Petz, Lawrence; Yin, Dwight
Source
Cell. 186(6)
Subject
Language
Abstract
Previously, two men were cured of HIV-1 through CCR5Δ32 homozygous (CCR5Δ32/Δ32) allogeneic adult stem cell transplant. We report the first remission and possible HIV-1 cure in a mixed-race woman who received a CCR5Δ32/Δ32 haplo-cord transplant (cord blood cells combined with haploidentical stem cells from an adult) to treat acute myeloid leukemia (AML). Peripheral blood chimerism was 100% CCR5Δ32/Δ32 cord blood by week 14 post-transplant and persisted through 4.8 years of follow-up. Immune reconstitution was associated with (1) loss of detectable replication-competent HIV-1 reservoirs, (2) loss of HIV-1-specific immune responses, (3) in vitro resistance to X4 and R5 laboratory variants, including pre-transplant autologous latent reservoir isolates, and (4) 18 months of HIV-1 control with aviremia, off antiretroviral therapy, starting at 37 months post-transplant. CCR5Δ32/Δ32 haplo-cord transplant achieved remission and a possible HIV-1 cure for a person of diverse ancestry, living with HIV-1, who required a stem cell transplant for acute leukemia.