Patient HIV Free After Stem Cell Transplant

By on February 13, 2009

HIV

A patient with acute leukemia and HIV infection remained virus free after receiving stem cells from a donor who is genetically resistant to HIV.
Infection with HIV requires the presence of a CD4 receptor and a chemokine receptor, principally chemokine receptor 5 (CCR5).

Gero Hütter of the Department of Hematology, Oncology, and Transfusion Medicine at the Charité Universitätsmedizin in Berlin realized that by replacing his patient’s immune cells with cells lacking the CCR5 receptor, his patient might be less vulnerable to HIV infection.

The image is an electron micrograph of HIV budding from cultured lymphocyte.

Hütter performed the bone marrow transplant after finding a donor lacking the CCR5 receptor, and twenty months after transplantation and discontinuation of antiretroviral therapy, the patient remains HIV free.

Bone marrow transplantation has periodically been advocated as a path to HIV cure, but past efforts have been uniformly unsuccessful. However, the case does suggest that targeting CCR5 by other methods, molecular inactivators or RNA fragments that downregulate expression, might be a powerful strategy for delaying onset of disease, if not actually achieving cure.

References:
1. Gero Hütter, et al. Long-Term Control of HIV by CCR5 Delta32/Delta32 Stem-Cell Transplantation. N Engl J Med. 2009 Feb 12;360(7):692-8. PMID: 19213682.
2. Abigail Zuger, MD. Stem-Cell Transplantation Enables Long-Term HIV Control. AIDS Clinical Care.
3. Image from Centers for Disease Control and Prevention

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