Stem Cell Therapy and Its Significance in HIV Infection.

Khizer Khalid,Ayden Charlene Cooper,Gutteridge Jean-Charles,Hussam Al Hennawi,Sandeep Padda,Abdulelah H Almanie,Ransirini Wijeratne Fernando,Krutagni Adwait Mehta,Jaskamal Padda

doi:10.7759/cureus.17507

Khizer Khalid, Ayden Charlene Cooper + Show 7 more

Open Access

https://doi.org/10.7759/cureus.17507

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Journal: Cureus	Publication Date: Aug 27, 2021
Citations: 5	License type: cc-by

Affiliation: Orlando Health

Abstract

Human immunodeficiency virus (HIV) infection is a major global public health issue. Despite this, the only treatment available in mainstay is antiretroviral therapy. This treatment is not curative, it needs to be used lifelong, and there are many issues with compliance and side effects. In recent years, stem cell therapy has shown promising results in HIV management, and it can have a major impact on the future of HIV treatment and prevention. The idea behind anti-HIV hematopoietic stem/progenitor cell (HSPC)-directed gene therapy is to genetically engineer patient-derived (autologous) HSPC to acquire an inherent resistance to HIV infection. Multiple stem-cell-based gene therapy strategies have been suggested that may infer HIV resistance including anti-HIV gene reagents and gene combinatorial strategies giving rise to anti-HIV gene-modified HSPCs. Such stem cells can hamper HIV progression in the body by interrupting key stages of HIV proliferation: viral entry, viral integration, HIV gene expression, etc.Hematopoietic stem cells (HSCs) may also protect leukocytes from being infected. Additionally, genetically engineered HSCs have the ability to continuously produce protected immune cells by prolonged self-renewal that can attack the HIV virus. Therefore, a successful treatment strategy has the potential to control the infection at a steady state and eradicate HIV from patients. This will allow for a potential future benefit with stem cell therapy in HIV treatment.

Highlights

BackgroundWHO estimated an human immunodeficiency virus (HIV) prevalence of 37.7 million people by the end of 2020, with 680,000 deaths due to HIV-related causes
In a large-scale phase 2 trial on Hematopoietic stem cells (HSCs)-based gene therapy, researchers made the use of autologous adult HSCs transduced with a retroviral vector containing the trans-activator of transcription and viral protein R-specific anti-HIV ribozyme in order to produce cells that are less prone to subsequent infection [45]
Demonstrated by the first case of HIV infection remission achieved by bone marrow transplant, anti-HIV HPSC-based stem cell therapy and gene engineering have substantiated a potential next-generation approach to fight against HIV infection

Summary

Introduction

WHO estimated an human immunodeficiency virus (HIV) prevalence of 37.7 million people by the end of 2020, with 680,000 deaths due to HIV-related causes. This took place after a successful stem cell transplantation from a homozygous defective HSPC donor in an HIV-infected individual. This case shed light on possible viral escape mutations associated with the X4 HIV tropic form, constituting a major limitation to CCR5 inhibition strategies [24]. In a large-scale phase 2 trial on HSC-based gene therapy, researchers made the use of autologous adult HSCs transduced with a retroviral vector containing the trans-activator of transcription and viral protein R (tat-vpr)-specific anti-HIV ribozyme in order to produce cells that are less prone to subsequent infection [45]. Stem cells had been capable of recovering and restoring the mucosal immunity very early on, even without the use of antiviral drugs, thereby increasing the host’s antiviral response

Conclusions

Disclosures

Findings

47. Alkhatib G