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HIV eradication—from Berlin to Boston

Nature Biotechnology volume 32, pages 315–316 (2014)Cite this article

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To the Editor:

In the first reported case of a cure, the HIV-positive Berlin patient received two hematopoietic (or blood) stem cell transplants during treatment for leukemia. Of note, the stem cell donor was both an appropriate tissue match and also homozygous for a 32-bp deletion in the chemokine CC-motif receptor 5 gene (CCR5Δ32). This mutation removes an essential HIV-1 entry co-receptor, and homozygotes have high levels of resistance to the virus. The transplantation was undertaken in the belief that these cells could provide the patient with a replacement, donor-derived immune system that was also HIV-resistant. To date, the patient has gone more than five years with no detectable HIV-1 in his body, despite cessation of all anti-HIV drug therapy since before the first transplantation2,6. However, the leukemia treatment also included an aggressive cytoablative conditioning regimen to destroy the cancer, and graft-versus-host disease (GVHD) developed, where donor-derived T cells can attack any residual leukemia, but in this case they could also have targeted any remaining HIV-infected cells in his body that formed the reservoir of the disease. This leads to the formal possibility that the HIV-resistant genotype of the donor was irrelevant, or played only a minor role, in the positive outcome.

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Acknowledgements

The authors acknowledge support from the National Institutes of Health grants U19 AI096111, P01 HL73104 and R01 AI080326, and the California Institute for Regenerative Medicine grant DR1-01490.

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Authors and Affiliations

  1. University of Southern California, Los Angeles, California, USA

    Paula M Cannon

  2. University of California Los Angeles, Los Angeles, California, USA

    Donald B Kohn

  3. Fred Hutchinson Cancer Research Center and University of Washington, Seattle, Washington, USA

    Hans-Peter Kiem

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  1. Paula M Cannon
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  2. Donald B Kohn
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  3. Hans-Peter Kiem
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Correspondence to Paula M Cannon.

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Cannon, P., Kohn, D. & Kiem, HP. HIV eradication—from Berlin to Boston. Nat Biotechnol 32, 315–316 (2014). https://doi.org/10.1038/nbt.2868

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