HIV cure has been reported for five individuals who underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT) with cells from CCR5Δ32 homozygous donors. By contrast, viral rebound has occurred in other people living with HIV who interrupted antiretroviral treatment after undergoing allo-HSCT, with cells mostly from wild-type CCR5 donors. Here we report the case of a male individual who has achieved durable HIV remission following allo-HSCT with cells from an unrelated HLA-matched (9 of 10 matching for HLA-A, HLA-B, HLA-C, HLA-DRB1 and HLA-DQB1 alleles) wild-type CCR5 donor to treat an extramedullary myeloid tumor. To date, plasma viral load has remained undetectable for 32 months after the interruption of antiretroviral treatment. Treatment with ruxolitinib has been maintained during this period to treat chronic graft-versus-host disease. Low levels of proviral DNA were detected sporadically after allo-HSCT, including defective but not intact HIV DNA. No virus could be amplified in cultures of CD4⁺ T cells obtained after antiretroviral treatment interruption, while CD4⁺ T cells remained susceptible to HIV-1 infection in vitro. Declines in HIV antibodies and undetectable HIV-specific T cell responses further corroborate the absence of viral rebound after antiretroviral treatment interruption. These results suggest that HIV remission could be achieved in the context of allo-HSCT with wild-type CCR5.

据报道，有 5 名个体接受了同种异体造血干细胞移植 （allo-HSCT），使用来自 CCR5Δ32 纯合供体的细胞。相比之下，病毒反弹发生在其他在接受同种异体造血干细胞移植后中断抗逆转录病毒治疗的 HIV 感染者中，细胞主要来自野生型 CCR5 供体。在这里，我们报告了一名男性个体在异种造血干细胞移植后实现持久 HIV 缓解的病例，该细胞来自无关的 HLA 匹配 （HLA-A、HLA-B、HLA-C、HLA-DRB1 和 HLA-DQB1 等位基因匹配的 10 个中的 9 个）野生型 CCR5 供体治疗髓外骨髓瘤。迄今为止，在中断抗逆转录病毒治疗后 32 个月内仍无法检测到血浆病毒载量。在此期间，一直维持 ruxolitinib 治疗以治疗慢性移植物抗宿主病。allo-HSCT 后偶发检测到低水平的前病毒 DNA，包括有缺陷但不完整的 HIV DNA。在抗逆转录病毒治疗中断后获得的 CD4⁺ T 细胞培养物中不能扩增病毒，而 CD4⁺ T 细胞在体外仍然易受 HIV-1 感染。HIV 抗体的下降和检测不到的 HIV 特异性 T 细胞反应进一步证实了抗逆转录病毒治疗中断后病毒反弹的缺失。这些结果表明，在野生型 CCR5 的同种异体 HSCT 背景下可以实现 HIV 缓解。