Two patients achieved long-term remission of HIV following allogeneic hematopoietic stem cell transplantation (HSCT) with HIV-susceptible donor cells, but the virus returned when they stopped taking antiretroviral therapy, according to an article being published in Annals of Internal Medicine.
A major challenge in finding a cure for HIV is the persistence of latently infected cells. Sustained HIV remission was demonstrated in a patient who received allogeneic HSCT from a donor with HIV-resistant cells, but it is not known the extent to which latently infected cells in the blood and other tissues are reduced in patients transplanted with HIV susceptible cells. To determine if allogeneic HSCT with HIV-1 susceptible cells could lead to sustained antiretroviral-free HIV remission, researchers had two patients who had undergone allogeneic HSCT and had no detectible HIV in their blood stop taking their antiretroviral therapy. Antiretroviral therapy was interrupted until HIV rebound was detected in the patients' blood and cerebral spinal fluid.
The researchers detected HIV rebound at 12 and 32 weeks; despite a significant reduction in reservoir size following transplantation. The author of an accompanying editorial suggests that these two cases show the complex interplay between virus and host and that there is still much more work to do before science can find a cure for HIV.