HIV-1 remission and possible cure in a woman after haplo-cord blood transplant
HIV-1 remission and possible cure in a woman after haplo-cord blood transplant
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DOI：
10.1016/j.cell.2023.02.030
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发表时间：
2023-03-16
期刊：
影响因子：
64.5
通讯作者：
Bryson, Yvonne
中科院分区：
文献类型：
--
作者：
Hsu, Jingmei;Van Besien, Koen;Bryson, Yvonne
此前，两名男子通过 CCR5A32 纯合子 (CCR5A32/A32) 同种异体成体干细胞移植治愈了 HIV-1。我们报告了一位混血女性的 HIV-1 首次缓解和可能的治愈，她接受了 CCR5A32/A32 单倍体脐带移植（脐带血细胞与成人的单倍体干细胞相结合）来治疗急性髓系白血病 (AML)。移植后第 14 周，外周血嵌合状态为 100% CCR5A32/A32 脐带血，并持续 4.8 年的随访。免疫重建与以下因素相关：(1) 可检测到的具有复制能力的 HIV-1 病毒库的丧失；(2) HIV-1 特异性免疫反应的丧失；(3) 对 X4 和 R5 实验室变异的体外耐药性，包括移植前自体潜伏病毒库分离株；(4) 从移植后 37 个月开始，停止抗逆转录病毒治疗，18 个月的 HIV-1 控制无病毒血症。 CCR5A32/A32 单倍索移植为一名患有 HIV-1 的不同血统的人带来了缓解，并可能治愈了 HIV-1，该人需要干细胞移植来治疗急性白血病。
Previously, two men were cured of HIV-1 through CCR5A32 homozygous (CCR5A32/A32) allogeneic adult stem cell transplant. We report the first remission and possible HIV-1 cure in a mixed-race woman who received a CCR5A32/A32 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% CCR5A32/ A32 cord blood by week 14 post-transplant and persisted through 4.8 years of follow-up. Immune reconsti-tution 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 ther-apy, starting at 37 months post-transplant. CCR5A32/A32 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.