1. HIV-1 remission and possible cure in a woman after haplo-cord blood transplant
- Author
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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, and Yin, Dwight
- Subjects
Medical Microbiology ,Biomedical and Clinical Sciences ,Cardiovascular Medicine and Haematology ,Immunology ,Stem Cell Research - Nonembryonic - Human ,Childhood Leukemia ,Hematology ,Pediatric ,Regenerative Medicine ,Transplantation ,Stem Cell Research ,Infectious Diseases ,Cancer ,Pediatric Cancer ,Stem Cell Research - Umbilical Cord Blood/ Placenta - Human ,Clinical Trials and Supportive Activities ,HIV/AIDS ,Clinical Research ,Rare Diseases ,Stem Cell Research - Umbilical Cord Blood/ Placenta ,Infection ,Male ,Adult ,Female ,Humans ,Hematopoietic Stem Cell Transplantation ,HIV-1 ,Cord Blood Stem Cell Transplantation ,Fetal Blood ,HIV Infections ,Leukemia ,Myeloid ,Acute ,International Maternal Pediatric Adolescent AIDS Clinical Trials Network (IMPAACT) P1107 Team ,HIV CCR5 dela 32 transplant ,HIV cure ,HIV remission ,Biological Sciences ,Medical and Health Sciences ,Developmental Biology ,Biological sciences ,Biomedical and clinical sciences - 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.
- Published
- 2023