Dynamics of the HIV reservoir after allogeneic haematopoietic stem-cell transplantation (HSCT)

The changes in immune and viral markers after allogeneic stem cell transplantation that led to the high-profile HIV cures in six people, including Timothy Ray Brown, Adam Castelijio (the Berlin and London patients), including when this procedure was not successful, are reported in the June issue of Lancet HIV.

The analysis reported the variable reservoir outcomes in multiple blood, tissue and cell sites from 30 people in the IciStem cohort who were living with HIV and diagnosed with severe haematological cancers and who underwent HSCT treatment from 2009 to 2019. Only 10/30 transplants involved donors with CCR5 d-32 mutation, which is protective against HIV infection. Three cases involved umbilical cord donors.

Irrespective of the role in curing HIV in the successful cases, HSCT is a complex and difficult treatment.

Salgado M et al. Dynamics of virological and immunological markers of HIV persistence after allogeneic haematopoietic stem-cell transplantation in the IciStem cohort: a prospective observational cohort study. The Lancet HIV Volume 11 Issue 6 e389 – e405.
https://doi.org/10.1016/S2352-3018(24)00090-0