Koelsch K.,University of New South Wales |
Koelsch K.,2 St Vincents Hospital |
Koelsch K.,University of Melbourne |
Koelsch K.,4 The Alfred Hospital |
And 5 more authors.
Journal of Acquired Immune Deficiency Syndromes | Year: 2017
BACKGROUND:: Allogeneic hematopoietic stem cell transplantation (HSCT) can lead to significant changes to the HIV reservoir and HIV immune responses, indicating that further characterisation of HIV infected patients undergoing HSCT is warranted. METHODS:: We studied three patients who underwent HSCT after either reduced intensity conditioning or myeloablative conditioning regimen. We measured HIV antigens and antibodies (Ag/Ab), HIV specific CD4+ T cell responses, HIV RNA and DNA in plasma, peripheral blood mononuclear cells (PBMCs), isolated CD4+ T cells from peripheral blood and lymph node cells. The patients remained on ART throughout the follow up period. RESULTS:: All patients have been in continued remission for 4-6 years post-HSCT. Analyses of HIV RNA and DNA levels showed substantial reductions in HIV reservoir related measurements in all three patients, changes in immune response varied with pronounced reductions in two patients and a less dramatic reduction in one patient. One patient experienced unexpected viral rebound 4 years after HSCT. CONCLUSION:: These three cases highlight the substantial changes to the HIV reservoir and the HIV immune response in patients undergoing allogeneic HSCT. The viral rebound observed in one patient indicates that replication competent HIV can re-emerge several years following HSCT despite these marked changes. Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.