Impact of Allogeneic Hematopoietic Stem Cell Transplantation on the HIV Reservoir and Immune Response in 3 HIV-Infected Individuals. (1st July 2017)

• Record Type: Journal Article
• Authors: Koelsch, Kersten K.; Rasmussen, Thomas A.; Hey-Nguyen, William J.; Pearson, Chester; Xu, Yin; Bailey, Michelle; Marks, Katherine H.; Sasson, Sarah C.; Taylor, Mark S.; Tantau, Robyn; Obeid, Solange; Milner, Brad; Morrissey, Orla; Pinto, Angie N.; Suzuki, Kazuo; Busch, Michael P.; Keating, Sheila M.; Kaiser, Philipp; Yukl, Steven; Wong, Joseph K.; Hiener, Bonnie M.; Palmer, Sarah; Zaunders, John; Post, Jeffrey J.; Chan, Derek J.; Avery, Sharon; Milliken, Sam T.; Kelleher, Anthony D.; Lewin, Sharon R.; Cooper, David A.
• Is Part Of: Journal of acquired immune deficiency syndromes. Volume 75(2017)Supplement 3
• Publication Date: 2017-07-01
• Subjects: HIV -- reservoirs -- stem cell transplant -- immune response -- stem cells; AIDS (Disease) -- Periodicals; Acquired Immunodeficiency Syndrome -- Periodicals; AIDS (Disease); Periodicals; 616.9792005
• DOI: 10.1097/QAI.0000000000001381
• Languages: English
• ISSNs: 1525-4135

Abstract

Abstract : Background: Allogeneic hematopoietic stem cell transplantation (HSCT) can lead to significant changes to the HIV reservoir and HIV immune responses, indicating that further characterization of HIV-infected patients undergoing HSCT is warranted. Methods: We studied 3 patients who underwent HSCT after either reduced intensity conditioning or myeloablative conditioning regimen. We measured HIV antigens and antibodies (Ag/Ab), HIV-specific CD4 + T-cell responses, HIV RNA, and DNA in plasma, peripheral blood mononuclear cells, isolated CD4 + T cells from peripheral blood, and lymph node cells. The patients remained on antiretroviral therapy throughout the follow-up period. Results: All patients have been in continued remission for 4–6 years post-HSCT. Analyses of HIV RNA and DNA levels showed substantial reductions in HIV reservoir–related measurements in all 3 patients, changes in immune response varied with pronounced reductions in 2 patients and a less dramatic reduction in 1 patient. One patient experienced unexpected viral rebound 4 years after HSCT. Conclusions: These 3 cases highlight the substantial changes to the HIV reservoir and the HIV immune response in patients undergoing allogeneic HSCT. The viral rebound observed in 1 patient indicates that replication competent HIV can re-emerge several years after HSCT despite these marked changes. Abstract : Supplemental Digital Content is Available in the Text.