Plasma Viremia and Cellular HIV-1 DNA Persist Despite Autologous Hematopoietic Stem Cell Transplantation for HIV-Related Lymphoma

Cillo, Anthony R. BS*; Krishnan, Amrita MD; Mitsuyasu, Ronald T. MD; McMahon, Deborah K. MD*; Li, Shirley MD§; Rossi, John J. PhD; Zaia, John A. MD§; Mellors, John W. MD*

JAIDS Journal of Acquired Immune Deficiency Syndromes: 1 August 2013 - Volume 63 - Issue 4 - p 438–441
doi: 10.1097/QAI.0b013e31828e6163
Brief Report: Basic and Translational Science

Abstract: A cure of HIV-1 has been achieved in one individual through allogeneic stem cell transplantation with a CCR5[INCREMENT]32 homozygous donor. Whether myeloablation and autologous stem cell transplantation for lymphoma in patients on suppressive antiretroviral therapy can eliminate HIV-1 reservoirs is unknown. Low-level plasma viremia and total HIV-1 DNA and 2-LTR circles in blood mononuclear cells were quantified after autologous transplantation in 10 patients on suppressive antiretroviral therapy using quantitative polymerase chain reaction assays capable of single-copy nucleic acid detection. Plasma viremia was detectable in 9 patients, whereas HIV-1 DNA was detectable in all 10 patients, indicating that HIV-1 had not been eliminated.

*Division of Infectious Diseases, School of Medicine, University of Pittsburgh, Pittsburgh, PA;

Department of Hematology/Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA;

Center for Clinical AIDS Research and Education, David Geffen School of Medicine Medicine, University of California, Los Angeles, Los Angeles, CA;

§Division of Virology, City of Hope National Medical Center, Duarte, CA; and

Department of Molecular and Cellular Biology, City of Hope National Medical Center, Duarte, CA.

Correspondence to: John W. Mellors, MD, University of Pittsburgh School of Medicine, S818 Scaife Hall, 3550 Terrace Street, Pittsburgh, PA 15261 (e-mail: jwm1@pitt.edu).

Supported by funding from the National Institute of Allergy and Infectious Diseases, National Institutes of Health, AIDS Clinical Trials Group Grant 3U01 AI069494-03S1, the National Institutes of Health Grant AI-28697, the National Cancer Institute Grant CA-121947, and the American Foundation for AIDS Research, amfAR Grant 107865-48-RGRL.

J.W.M. is a consultant for Gilead Sciences and RFS Pharma and owns shares of RFS Pharma. A.R.C., A.K., R.T.M., D.K.M., S.L., J.J.R., and J.A.Z. have no conflicts of interest relevant to this article.

J.J.R., J.A.Z., and J.W.M. designed the study. A.R.C. performed the experiments, and A.R.C. and J.W.M. analyzed the resulting data. A.K., J.A.Z., S.L., R.T.M., and D.K.M. provided samples for the study. A.R.C. and J.W.M. wrote the manuscript, and all authors provided critical input.

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Presented at the Fifth International Workshop on HIV Persistence During Therapy in December 6-9, 2011 in St Maarten, West Indies, and as an Oral Abstract at the 19th Conference on Retroviruses and Opportunistic Infections, March 5-8, 2012, Seattle, WA.

Received November 19, 2012

Accepted February 20, 2013

© 2013 by Lippincott Williams & Wilkins