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• 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.

Sources:

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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