NEWS
14 March 2019

Transplant success reignites interest in reprogramming cells against HIV

Editing cells to lack the CCR5 receptor may prove more feasible for more people.

Colin Barras

Colin Barras

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T cells infected with HIV. Comstock/Stockbyte/Getty

Last week, researchers took a small but significant step forward in the battle against HIV. A person named in public only as the ‘London patient’ has apparently been left free of the virus after a bone marrow transplant for a form of blood cancer. The announcement — made jointly at the Conference on Retroviruses and Opportunistic Infections in Seattle, Washington, and in a Nature paper¹ — came with the caveat that the procedure is too risky and expensive to adopt widely for treatment of HIV. However, it has also sparked new interest in a technique to combat the virus by reprogramming the human immune system using gene-editing technology. HIV wreaks havoc on the immune system by forcing its way inside CD4 T immune cells, within which the virus replicates itself and ultimately destroys the cells. However, since the mid-1990s, researchers have been aware of a vulnerability in this attack strategy. HIV typically enters T cells by targeting a protein called C-–C chemokine receptor type 5 (CCR5), found on the cell surface. By chance, about 1–3% of people of European descent produce only non-functioning forms of CCR5². This altered version makes it much harder for HIV to enter their T cells³, breaking the viral replication cycle.

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doi: https://doi.org/10.1038/d41591-019-00011-y

**An earlier version of this story included a quote that mischaracterized the status of a clinical study. The article had stated: There were concerns that CSL Behring was keen to drop Calimmune’s HIV work, even though the clinical trial was at an advanced stage. Those fears proved well-founded. “Calimmune has been acquired and is no longer pursuing this study, which has been terminated,” says Ronald Mitsuyasu, a professor of medicine in hematology–oncology at the University of California, Los Angeles, who was the principal investigator on the clinical trial. The phase 1/2 study was actually completed. The agent did not move into a phase 3 trial; however, CSL Behring is funding an additional external study that might be able to demonstrate efficacy. The story has been updated for accuracy.

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