Long-term reduction in peripheral blood HIV type 1 reservoirs following reduced-intensity conditioning allogeneic stem cell transplantation

J Infect Dis. 2013 Jun 1;207(11):1694-702. doi: 10.1093/infdis/jit086. Epub 2013 Mar 4.


Background: The long-term impact of allogeneic hematopoietic stem cell transplantation (HSCT) on human immunodeficiency virus type 1 (HIV-1) reservoirs in patients receiving combination antiretroviral therapy (cART) is largely unknown.

Methods: We studied the effects of a reduced-intensity conditioning allogeneic HSCT from donors with wild-type-CCR5(+) cells on HIV-1 peripheral blood reservoirs in 2 patients heterozygous for the ccr5Δ32 mutation. In-depth analyses of the HIV-1 reservoir size in peripheral blood, coreceptor use, and specific antibody responses were performed on samples obtained before and up to 3.5 years after HSCT receipt.

Results: Although HIV-1 DNA was readily detected in peripheral blood mononuclear cells (PBMCs) before and 2-3 months after HSCT receipt, HIV-1 DNA and RNA were undetectable in PBMCs, CD4(+) T cells, or plasma up to 21 and 42 months after HSCT. The loss of detectable HIV-1 correlated temporally with full donor chimerism, development of graft-versus-host disease, and decreases in HIV-specific antibody levels.

Conclusions: The ability of donor cells to engraft without evidence of ongoing HIV-1 infection suggests that HIV-1 replication may be fully suppressed during cART and does not contribute to maintenance of viral reservoirs in peripheral blood in our patients. HSCTs with wild-type-CCR5(+) donor cells can lead to a sustained reduction in the size of the peripheral reservoir of HIV-1.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Retroviral Agents / administration & dosage
  • Antiretroviral Therapy, Highly Active / methods
  • Gene Deletion
  • HIV Infections / drug therapy
  • HIV Infections / virology*
  • HIV-1 / isolation & purification*
  • HIV-1 / pathogenicity
  • Heterozygote
  • Humans
  • Male
  • Receptors, CCR5 / genetics
  • Receptors, CCR5 / metabolism
  • Receptors, HIV / genetics
  • Receptors, HIV / metabolism
  • Stem Cell Transplantation*
  • Transplantation, Homologous*
  • Viral Load*


  • Anti-Retroviral Agents
  • Receptors, CCR5
  • Receptors, HIV