1. Bone Marrow Transplantation: A Novel Treatment for HIV Seropositives
Singh A.1, Pal R.1, Verma A.S.2
1Amity Institute of Biotechnology , Amity University Uttar Pradesh, Sector-125, NOIDA, UP, India
2 Pro-Vice-Chancellor, Jadavpur University 188 Raja S C Mallik Road, Jadavpur, Kolkata WB, India
ABSTRACT
INTRODUCTION
After four years of bone marrow transplantation the patient has remained free of HIV and immune reconstitution has been observed.
This type of treatment can be helpful for those who do not respond to anti-retroviral treatment.
HIV infection is always dealt with fretfulness, because HIV infections lead to an incurable disease commonly known as Acquired Immuno-deficiency Syndrome (AIDS). A full blown AIDS is the final chapter of an individual infected with HIV . Still, the fact remains as “HIV Infections can be controlled and cannot be cured”.
In the recent past, it has been reported that an HIV seropositive has been cured of HIV by transplanting a bone marrow with mutation CCR5 32/ 32. So far, it is considered as interesting observation in case of incurable infections like HIV. This patient has remained HIV-free since last 4 years. To date, all efforts to cure HIV by diverse means have not proven successful to cure HIV infections. Although bone marrow transplantation has shown some promises to cure HIV in future. There are skepticism about this modality of treatment in the form of HIV rebound, evolution of X-4 strain and even the possibilities of activation of HIV from a long-term reservoir , etc. Bone marrow transplantation has opened new vistas and generated a hope for HIV patients, but there are real limitations to evolve bone marrow transplantation as a modality to treat HIV infections e.g., this mutation exists in few cases and that only in Caucasian population. This successful report warrants expansion of research in the direction to search and find similar mutation among other races ,which are badly affected by HIV. At present bone marrow transplantation is a good option for those patients who do not respond to HAART or are in terminal stages of HIV infection and happen to have the option of a rare donor of this CCR5 genotype.
It had been observed that certain individuals do not get infected with HIV even though they were exposed to HIV numerous times. These individuals are considered as having natural resistance against HIV infections.
.HIV affects specific cells of the immune system, called CD4+ cells, or T cells.
CD4 is the primary receptor for HIV infections, but chemokine receptors like CXCR4 and CCR5 have been shown to be essential for HIV infections.
The natural resistance to HIV infections is attributable to mutation in co-receptor CCR5 sequence. Though, this mutation has been attributed to low frequency of ~1% among the Caucasian race only.
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The patient was a 40 years old male HIV seropositive under anti-HIV treatment. HIV infection was under control but the patient was suffering from AML for which he had to undergo bone marrow transplantation.
The patient was transplanted with a donor having homozygous mutation in CCR5 gene so the patient may become naturally resistant to HIV.
ACKNOWLEDGEMENTS
The authors are thankul to Mr. Dinesh Kumar for his secretarial assistance.