Curating evidence for a cure of HIV-1 infection by hematopoietic stem cell transplantation

Abstract

A cure of HIV-1 infection has previously been described in two individuals undergoing allogeneic hematopoietic stem cell transplants from homozygous carriers of the CCR5Δ32 gene variant, which confers HIV-1 resistance. Two recent reports corroborate these earlier studies, underscoring that in HIV-1-infected persons with hematologic malignancies, these procedures may provide a realistic perspective for a cure of HIV-1 infection.

Figure 1.. Hematopoietic stem cell transplant from CCR5∆32 homozygous donors can be used to cure HIV-1

(A) CCR5 is a co-receptor needed for successful entry and subsequent infection of cells by HIV-1. Truncation of the protein through mutation, vis-à-vis CCR5∆32, prevents HIV-1 from entering the cell, thus infection cannot be established. Transplantation of stem cells from a donor homozygous for CCR5∆32 results in the recipient possessing cells resistant to HIV-1. (B) Jensen et al. and Hsu et al. both report on two individuals who received stem cell transplantations, albeit via two different methods. Jensen and colleagues report on an HIV-1 cure in a 53-year-old male who received a CCR5∆32 allogeneic stem cell transplant, similar to the previous two successful cure study subjects. Hsu and colleagues instead are the first to demonstrate an HIV-1 cure in a mixed-race woman via CCR5∆32 cord blood transplant. Figure created using BioRender.