Long-term Control of HIV by CCR5 Delta32/Delta32 Stem-Cell Transplantation

N Engl J Med. 2009 Feb 12;360(7):692-8. doi: 10.1056/NEJMoa0802905.

Abstract

Infection with the human immunodeficiency virus type 1 (HIV-1) requires the presence of a CD4 receptor and a chemokine receptor, principally chemokine receptor 5 (CCR5). Homozygosity for a 32-bp deletion in the CCR5 allele provides resistance against HIV-1 acquisition. We transplanted stem cells from a donor who was homozygous for CCR5 delta32 in a patient with acute myeloid leukemia and HIV-1 infection. The patient remained without viral rebound 20 months after transplantation and discontinuation of antiretroviral therapy. This outcome demonstrates the critical role CCR5 plays in maintaining HIV-1 infection.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Retroviral Agents / therapeutic use
  • CD4 Antigens
  • CD4 Lymphocyte Count
  • CD4-Positive T-Lymphocytes / immunology
  • DNA, Viral / blood
  • Genetic Predisposition to Disease
  • HIV Infections / drug therapy
  • HIV Infections / immunology
  • HIV Infections / therapy*
  • HIV-1* / genetics
  • Homozygote
  • Humans
  • Male
  • RNA, Viral / blood
  • Receptors, CCR5 / genetics*
  • Stem Cell Transplantation*
  • Transplantation Chimera
  • Transplantation, Homologous
  • Viral Load

Substances

  • Anti-Retroviral Agents
  • CD4 Antigens
  • DNA, Viral
  • RNA, Viral
  • Receptors, CCR5