Transplantation of selected or transgenic blood stem cells – a future treatment for HIV/AIDS?

Interaction with the chemokine receptor, CCR5, is a necessary precondition for maintaining HIV-1 infection. Individuals with the CCR5-delta32 deletion who lack this receptor are highly resistant to infection by the most common forms of HIV-1. We recently reported on the successful transplantation in an HIV-1-positive patient of allogeneic stem cells homozygous for the CCR5-delta32 allele, which stopped viral replication for more than 27 months without antiretroviral therapy. Here, we report on the results of a meeting regarding the potential implications and future directions of stem cell-targeted HIV treatments. The meeting drew together an international panel of hematologists, immunologists, HIV specialists and representatives from bone marrow donor registries. The meeting came to an agreement to support further attempts to use CCR5-delta32 deleted stem cells, for example, prescreened cord blood stem cells, to treat probable HIV-1-positive patients with malignancies. Furthermore, improvement of HIV-1 therapy that interferes with the entry mechanism seems to be a promising approach in HIV-1-infected patients with no matching CCR5-delta32 deleted donor.