A Possible Sterilizing Cure of HIV-1 Infection Without Stem Cell Transplantation.
A Possible Sterilizing Cure of HIV-1 Infection Without Stem Cell Transplantation.
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DOI：
10.7326/l21-0297
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发表时间：
2022-01
影响因子：
39.2
通讯作者：
Yu, Xu G.
中科院分区：
文献类型：
--
作者：
Turk, Gabriela;Seiger, Kyra;Lian, Xiaodong;Sun, Weiwei;Parsons, Elizabeth M.;Gao, Ce;Rassadkina, Yelizaveta;Polo, Maria Laura;Czernikier, Alejandro;Ghiglione, Yanina;Vellicce, Alejandra;Varriale, Joseph;Lai, Jun;Yuki, Yuko;Martin, Maureen;Rhodes, Ajantha;Lewin, Sharon R.;Walker, Bruce D.;Carrington, Mary;Siliciano, Robert;Siliciano, Janet;Lichterfeld, Mathias;Laufer, Natalia;Yu, Xu G.
A sterilizing cure of HIV-1 infection has been reported in 2 persons living with HIV-1 who underwent allogeneic hematopoietic stem cell transplantations from donors who were homozygous for the CCR5Δ32 gene polymorphism. However, this has been considered elusive during natural infection. To evaluate persistent HIV-1 reservoir cells in an elite controller with undetectable HIV-1 viremia for more than 7 years in the absence of antiretroviral therapy. Detailed investigation of virologic and immunologic characteristics. Tertiary care centers in Buenos Aires, Argentina, and Boston, Massachusetts. A patient with HIV-1 infection and durable drug-free suppression of HIV-1 replication. Analysis of genome-intact and replication-competent HIV-1 using near-full-length individual proviral sequencing and viral outgrowth assays, respectively; analysis of HIV-1 plasma RNA by ultrasensitive HIV-1 viral load testing. No genome-intact HIV-1 proviruses were detected in analysis of a total of 1.188 billion peripheral blood mononuclear cells and 503 million mononuclear cells from placental tissues. Seven defective proviruses, some of them derived from clonally expanded cells, were detected. A viral outgrowth assay failed to retrieve replication-competent HIV-1 from 150 million resting CD4 T cells. No HIV-1 RNA was detected in 4.5 mL of plasma. Absence of evidence for intact HIV-1 proviruses in large numbers of cells is not evidence of absence HIV-1 infection. A sterilizing cure of HIV-1 can never be empirically proved. Genome-intact and replication-competent HIV-1 were not detected in an elite controller despite analysis of massive numbers of cells from blood and tissues, suggesting that this patient may have naturally achieved a sterilizing cure of HIV-1 infection. These observations raise the possibility that a sterilizing cure may be an extremely rare but possible outcome of HIV-1 infection. National Institute of Health and Bill and Melinda Gates Foundation
