title: Impact of Allogeneic Hematopoietic Stem Cell Transplantation on the HIV Reservoir and Immune Response in 3 HIV-Infected Individuals.
abstract: Allogeneic hematopoietic stem cell transplantation (HSCT) can lead to significant changes to the HIV reservoir and HIV immune responses, indicating that further characterization of HIV-infected patients undergoing HSCT is warranted.
  
  
  
  We studied 3 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, isolated CD4 T cells from peripheral blood, and lymph node cells. The patients remained on antiretroviral therapy throughout the follow-up period.
  
  
  
  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 3 patients, changes in immune response varied with pronounced reductions in 2 patients and a less dramatic reduction in 1 patient. One patient experienced unexpected viral rebound 4 years after HSCT.
  
  
  
  These 3 cases highlight the substantial changes to the HIV reservoir and the HIV immune response in patients undergoing allogeneic HSCT. The viral rebound observed in 1 patient indicates that replication competent HIV can re-emerge several years after HSCT despite these marked changes.
authors.affiliation: *The Kirby Institute, UNSW Medicine, UNSW Australia, New South Wales, Australia; †St Vincent's Hospital, Sydney, Darlinghurst, New South Wales, Australia; ‡The Peter Doherty Institute for Infection and Immunity, Royal Melbourne Hospital, The University of Melbourne, Victoria, Australia; §The Alfred Hospital, Melbourne, Victoria, Australia; ‖Monash University, Victoria, Australia; ¶Blood Systems Research Institute, San Francisco, CA; #University of California, San Francisco, CA; **Veterans Affairs Medical Centre, San Francisco, CA; ††The Westmead Institute for Medical Research, Westmead, New South Wales, Australia; ‡‡University of Sydney, Sydney, New South Wales, Australia; §§Prince of Wales Hospital, Randwick, New South Wales, Australia; ‖‖The Albion Centre, Surry Hills, New South Wales, Australia; ¶¶Prince of Wales Clinical School, UNSW Medicine, UNSW Australia, New South Wales, Australia; ##School of Public Health, UNSW Medicine, UNSW Australia, New South Wales, Australia; and ***The Kinghorn Cancer Centre, Darlinghurst, New South Wales, Australia.
authors.forename: Kersten K
authors.initials: KK
authors.lastname: Koelsch
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Rasmussen
authors.forename: William J
authors.initials: WJ
authors.lastname: Hey-Nguyen
authors.forename: Chester
authors.initials: C
authors.lastname: Pearson
authors.forename: Yin
authors.initials: Y
authors.lastname: Xu
authors.forename: Michelle
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authors.lastname: Bailey
authors.forename: Katherine H
authors.initials: KH
authors.lastname: Marks
authors.forename: Sarah C
authors.initials: SC
authors.lastname: Sasson
authors.forename: Mark S
authors.initials: MS
authors.lastname: Taylor
authors.forename: Robyn
authors.initials: R
authors.lastname: Tantau
authors.forename: Solange
authors.initials: S
authors.lastname: Obeid
authors.forename: Brad
authors.initials: B
authors.lastname: Milner
authors.forename: Orla
authors.initials: O
authors.lastname: Morrissey
authors.forename: Angie N
authors.initials: AN
authors.lastname: Pinto
authors.forename: Kazuo
authors.initials: K
authors.lastname: Suzuki
authors.forename: Michael P
authors.initials: MP
authors.lastname: Busch
authors.forename: Sheila M
authors.initials: SM
authors.lastname: Keating
authors.forename: Philipp
authors.initials: P
authors.lastname: Kaiser
authors.forename: Steven
authors.initials: S
authors.lastname: Yukl
authors.forename: Joseph K
authors.initials: JK
authors.lastname: Wong
authors.forename: Bonnie M
authors.initials: BM
authors.lastname: Hiener
authors.forename: Sarah
authors.initials: S
authors.lastname: Palmer
authors.forename: John
authors.initials: J
authors.lastname: Zaunders
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Post
authors.forename: Derek J
authors.initials: DJ
authors.lastname: Chan
authors.forename: Sharon
authors.initials: S
authors.lastname: Avery
authors.forename: Sam T
authors.initials: ST
authors.lastname: Milliken
authors.forename: Anthony D
authors.initials: AD
authors.lastname: Kelleher
authors.forename: Sharon R
authors.initials: SR
authors.lastname: Lewin
authors.forename: David A
authors.initials: DA
authors.lastname: Cooper
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology; D004279:DNA, Viral / Q000097:blood; D015658:HIV Infections / Q000276:immunology* / Q000628:therapy* / Q000821:virology; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood; D012074:Remission Induction; D019172:Transplantation Conditioning; D016896:Treatment Outcome; D019562:Viral Load / Q000276:immunology*; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D012367:RNA, Viral