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(London,Berlin,Dusseldorf, etc) Stem Cell Transplant HIV remission

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geobee:
This is a stem-cell Delta-32 experiment (aka Tim Brown).  Here's the juicy part (I always take my juice with a grain of salt!)

Scientists from the Institute for AIDS Research IrsiCaixa in Barcelona and the Gregorio Maranon Hospital in Madrid have managed to remove the virus from the blood and tissues of six patients using the treatment.

But the research, published on Monday in the Journal of Internal Medicine, said one patient now has no antibodies fighting the infection, suggesting it has been completely eliminated.

Here's the article -- it's short:

http://www.theolivepress.es/spain-news/2018/10/16/spanish-doctors-eliminate-hiv-from-patient-in-stem-cell-transplant-trial/

Jim Allen:
Well time will tell with this one, we all recall the kids who were "cured" but when testing a few years later it was back. Long term remission perhaps


--- Quote ---The patients are keeping up their antiretroviral treatment,
--- End quote ---


Currently the Berlin patient has a functional cure but even than he still has HIV in some tissues just not replicating or its in a dormet state in laymens terms.

Always something to learn though

Jim

geobee:
I thought it was interesting that the one patient had no anti-bodies at all.  If he goes for several years without anti-bodies -- well, that would be something.  Sign me up! 

[I *did* try to sign up a few years ago for a Sangamo D32 trial.  They couldn't get enough HIV out of my blood to do a genotype and I was DQ'd]

Jim Allen:
Even the Berlin patient had a few negative Elisa results if i recall for a while, anyhow i suspect it will be more a possible functional cure one day for some, with longer treatment gaps if it works out, we will see how time goes on. In the meantime it will be interesting to see the published results from this latest phase.

Jim

Jim Allen:
Here is an abstract BTW and ill fish out the full one later this week.

http://annals.org/aim/article-abstract/2707334/mechanisms-contribute-profound-reduction-hiv-1-reservoir-after-allogeneic-stem


--- Quote ---Mechanisms That Contribute to a Profound Reduction of the HIV-1 Reservoir After Allogeneic Stem Cell Transplant

Abstract
Background:
The multifactorial mechanisms associated with radical reductions in HIV-1 reservoirs after allogeneic hematopoietic stem cell transplant (allo-HSCT), including a case of HIV cure, are not fully understood.

Objective:
To investigate the mechanism of HIV-1 eradication associated with allo-HSCT.

Design:
Nested case series within the IciStem observational cohort.

Setting:
Multicenter European study.

Participants:
6 HIV-infected, antiretroviral-treated participants who survived more than 2 years after allo-HSCT with CCR5 wild-type donor cells.

Measurements:
HIV DNA analysis, HIV RNA analysis, and quantitative viral outgrowth assay were performed in blood, and HIV DNA was also measured in lymph nodes, ilea, bone marrow, and cerebrospinal fluid. A humanized mouse model was used for in vivo detection of the replication-competent blood cell reservoir. HIV-specific antibodies were measured in plasma.

Results:
Analysis of the viral reservoir showed that 5 of 6 participants had full donor chimera in T cells within the first year after transplant, undetectable proviral HIV DNA in blood and tissue, and undetectable replication-competent virus (<0.006 infectious unit per million cells). The only participant with detectable virus received cord blood stem cells with an antithymocyte globulin–containing conditioning regimen, did not develop graft-versus-host disease, and had delayed complete standard chimerism in T cells (18 months) with mixed ultrasensitive chimera. Adoptive transfer of peripheral CD4+ T cells to immunosuppressed mice resulted in no viral rebound. HIV antibody levels decreased over time, with 1 case of seroreversion.

Limitation:
Few participants.

Conclusion:
Allo-HSCT resulted in a profound long-term reduction in the HIV reservoir. Such factors as stem cell source, conditioning, and a possible “graft-versus-HIV-reservoir” effect may have contributed. Understanding the mechanisms involved in HIV eradication after allo-HSCT can enable design of new curative strategies.

Primary Funding Source:
The Foundation for AIDS Research (amFAR).
--- End quote ---

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