دورية أكاديمية
Extensive virologic and immunologic characterization in an HIV-infected individual following allogeneic stem cell transplant and analytic cessation of antiretroviral therapy: A case study.
| العنوان: | Extensive virologic and immunologic characterization in an HIV-infected individual following allogeneic stem cell transplant and analytic cessation of antiretroviral therapy: A case study. |
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| المؤلفون: | Nathan W Cummins, Stacey Rizza, Mark R Litzow, Stephane Hua, Guinevere Q Lee, Kevin Einkauf, Tae-Wook Chun, Frank Rhame, Jason V Baker, Michael P Busch, Nicolas Chomont, Patrick G Dean, Rémi Fromentin, Ashley T Haase, Dylan Hampton, Sheila M Keating, Steven M Lada, Tzong-Hae Lee, Sekar Natesampillai, Douglas D Richman, Timothy W Schacker, Stephen Wietgrefe, Xu G Yu, Joseph D Yao, John Zeuli, Mathias Lichterfeld, Andrew D Badley |
| المصدر: | PLoS Medicine, Vol 14, Iss 11, p e1002461 (2017) |
| بيانات النشر: | Public Library of Science (PLoS), 2017. |
| سنة النشر: | 2017 |
| المجموعة: | LCC:Medicine |
| مصطلحات موضوعية: | Medicine |
| الوصف: | BACKGROUND:Notwithstanding 1 documented case of HIV-1 cure following allogeneic stem cell transplantation (allo-SCT), several subsequent cases of allo-SCT in HIV-1 positive individuals have failed to cure HIV-1 infection. The aim of our study was to describe changes in the HIV reservoir in a single chronically HIV-infected patient on suppressive antiretroviral therapy who underwent allo-SCT for treatment of acute lymphoblastic leukemia. METHODS AND FINDINGS:We prospectively collected peripheral blood mononuclear cells (PBMCs) by leukapheresis from a 55-year-old man with chronic HIV infection before and after allo-SCT to measure the size of the HIV-1 reservoir and characterize viral phylogeny and phenotypic changes in immune cells. At day 784 post-transplant, when HIV-1 was undetectable by multiple measures-including PCR measurements of both total and integrated HIV-1 DNA, replication-competent virus measurement by large cell input quantitative viral outgrowth assay, and in situ hybridization of colon tissue-the patient consented to an analytic treatment interruption (ATI) with frequent clinical monitoring. He remained aviremic off antiretroviral therapy until ATI day 288, when a low-level virus rebound of 60 HIV-1 copies/ml occurred, which increased to 1,640 HIV-1 copies/ml 5 days later, prompting reinitiation of ART. Rebounding plasma HIV-1 sequences were phylogenetically distinct from proviral HIV-1 DNA detected in circulating PBMCs before transplantation. The main limitations of this study are the insensitivity of reservoir measurements, and the fact that it describes a single case. CONCLUSIONS:allo-SCT led to a significant reduction in the size of the HIV-1 reservoir and a >9-month-long ART-free remission from HIV-1 replication. Phylogenetic analyses suggest that the origin of rebound virus was distinct from the viruses identified pre-transplant in the PBMCs. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 1549-1277 1549-1676 |
| العلاقة: | http://europepmc.org/articles/PMC5705162?pdf=renderTest; https://doaj.org/toc/1549-1277Test; https://doaj.org/toc/1549-1676Test |
| DOI: | 10.1371/journal.pmed.1002461 |
| الوصول الحر: | https://doaj.org/article/6cb0f7ce4309430794213dddfb5bf122Test |
| رقم الانضمام: | edsdoj.6cb0f7ce4309430794213dddfb5bf122 |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 15491277 15491676 |
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| DOI: | 10.1371/journal.pmed.1002461 |