HIV-1 remission and possible cure in a woman after haplo-cord blood transplant

Previously, two men were cured of HIV-1 through CCR5A32 homozygous (CCR5A32/A32) allogeneic adult stem cell transplant. We report the first remission and possible HIV-1 cure in a mixed-race woman who received a CCR5A32/A32 haplo-cord transplant (cord blood cells combined with haploidentical stem cells from an adult) to treat acute myeloid leukemia (AML). Peripheral blood chimerism was 100% CCR5A32/ A32 cord blood by week 14 post-transplant and persisted through 4.8 years of follow-up. Immune reconsti-tution was associated with (1) loss of detectable replication-competent HIV-1 reservoirs, (2) loss of HIV-1 -specific immune responses, (3) in vitro resistance to X4 and R5 laboratory variants, including pre-transplant autologous latent reservoir isolates, and (4)18 months of HIV-1 control with aviremia, off antiretroviral ther-apy, starting at 37 months post-transplant. CCR5A32/A32 haplo-cord transplant achieved remission and a possible HIV-1 cure for a person of diverse ancestry, living with HIV-1, who required a stem cell transplant for acute leukemia.

Automated summary

A mixed-race woman with acute myeloid leukemia achieved remission and a possible cure for HIV-1 through a CCR5A32/A32 haplo-cord transplant. Follow-up showed consistent presence of CCR5A32/A32 cord blood cells and the loss of detectable HIV-1 reservoirs. This case demonstrates the potential of stem cell transplantation in achieving HIV-1 control and possible cure.