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HIV-1 remission and possible cure in a woman after haplo-cord blood transplant
- 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;
- Bone, Frederic;
- Browning, Renee;
- Bryson, Yvonne;
- Coletti, Anne;
- Glesby, Marshall J;
- Golner, Amanda;
- Hazra, Rohan;
- Hsu, Jingmei;
- Mitsuyasu, Ronald;
- Moore, Theodore B;
- Pahwe, Savita;
- Persaud, Deborah;
- Petz, Lawrence;
- Tobin, Nicole H;
- Warshaw, Meredith G;
- Yin, Dwight
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.
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