据报道，有 5 名接受 CCR5Δ32 纯合子捐赠者的同种异体造血干细胞移植 (allo-HSCT) 的人获得了艾滋病毒治愈。相比之下，其他艾滋病毒感染者在接受同种异体造血干细胞移植后中断抗逆转录病毒治疗时，出现了病毒反弹，其中大部分来自野生型 CCR5 供体。在这里，我们报告了一名男性的病例，该男性在来自无关 HLA 匹配（HLA-A、-B、-C、-DRB1 和 -DQB1 等位基因为 9/10 匹配）的异基因 HSCT 后获得了持久的 HIV 缓解。 CCR5 型供体用于治疗髓外骨髓瘤。迄今为止，在抗逆转录病毒治疗中断后的 32 个月内，血浆病毒载量一直无法检测到。在此期间一直维持鲁索替尼治疗以治疗慢性移植物抗宿主病。同种异体造血干细胞移植后，偶尔检测到低水平的前病毒 DNA，包括有缺陷但不完整的 HIV DNA。抗逆转录病毒治疗中断后获得的 CD4  T 细胞培养物中没有病毒能够扩增，而 CD4  T 细胞在体外仍然容易受到 HIV-1 感染。 HIV抗体的下降和无法检测到的HIV特异性T细胞反应进一步证实了抗逆转录病毒治疗中断后病毒没有反弹。这些结果表明，在使用野生型 CCR5 的同种异体造血干细胞移植 (allo-HSCT) 的背景下，可以实现 HIV 缓解。© 2024。作者获得 Springer Nature America, Inc. 的独家许可。

HIV cure has been reported for five individuals who received allogeneic hematopoietic stem cell transplant (allo-HSCT) from CCR5Δ32 homozygous donors. In contrast, viral rebound has occurred in other people living with HIV who interrupted antiretroviral treatment after receiving allo-HSCT, mostly from wild-type CCR5 donors. Here, we report the case of a male who has achieved durable HIV remission following allo-HSCT from an unrelated HLA-matched (9/10 matching for HLA-A, -B, -C, -DRB1 and -DQB1 alleles) wild-type CCR5 donor to treat an extramedullary myeloid tumor. To date, plasma viral load has remained undetectable for 32 months after the interruption of antiretroviral treatment. Treatment with ruxolitinib has been maintained during this period to treat chronic graft versus host disease. Low levels of proviral DNA were detected sporadically post-allo-HSCT, including defective but not intact HIV DNA. No virus could be amplified in cultures of CD4 + T cells obtained post antiretroviral treatment interruption, while CD4 + T cells remained susceptible to HIV-1 infection in vitro. Decline of HIV antibodies and undetectable HIV-specific T cell responses further corroborate the absence of viral rebound after antiretroviral treatment interruption. These results suggest that HIV remission could be achieved in the context of allo-HSCT with wild-type CCR5.© 2024. The Author(s), under exclusive licence to Springer Nature America, Inc.