Hiv cured with Bone marrow transplant

Aids Virus

 

At the beginning of the epidemic, immune suppression followed by a bone marrow transplant from a donor HIV-negative was proposed as a possible way to get rid of CD4 cells infected by HIV; an American activist even tried to transplant bone marrow from a baboon. A few people with AIDS who received bone marrow transplants before the advent of highly active antiretroviral therapy (HAART) had undetectable HIV levels after the procedure, but over time the virus returned.

In 2007, French researchers reported on a man with HIV who were taking HAART and had an undetectable viral load in their blood before receiving a bone marrow transplant. After transplantation, ultrasensitive tests found no genetic material of HIV in more than one million cells tested. But after the man had to stop taking antiretroviral therapy due to drug toxicity, both viral load in blood and HIV proviral DNA in cells once again it became detectable.
 

immunosuppressive therapy for Hiv

However, in a case that quickly made headlines news, infected by HIV in Berlin man who stopped ART after a bone marrow transplant has remained virus free for 38 months, according to the most sensitive tests available. CD4 cells from the patient themselves seem to have disappeared entirely, presumably due to immunosuppressive therapy used, and replaced by cells produced from donated bone marrow.2

The researchers who conducted the operation and monitoring have now pronounced the man cured of HIV infection, but the procedure used in this case is unlikely to be possible in many people due to very grueling course of chemotherapy, and CCR5 -matched need for a matched bone marrow transplant.3


Researchers do not yet fully understand the reasons for this result; many features of the case shown in research to provide partial explanations. For example, the marrow donor had a rare genetic variation (one homozygous mutation CCR5-Delta32) resulting in a complete absence of co-receptors CCR5 on donor immune cells (and thus the "replacement" cells of the transplant recipient ). Despite the lack of co-receptors CCR5 protects these cells from infection by R5-tropic virus does not explain why not become infected with X4-tropic, which must still be susceptible to viruses, and had been identified in the recipient prior to transplantation.

Despite this and other unanswered questions, researchers are beginning to explore how CCR5-deficient cells can be transferred to patients or donors created through gene therapy techniques.