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18.10.2018

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Spāņu zinātnieki apstiprina, ka viņiem izdevies sešus pacientus izārstēt no HIV, veicot cilmes šūnu transplantāciju. Zinātnieku pētījums publicēts medicīnas žurnālā Annals of Internal Medicine.
Tajā aprakstīta HIV infekcijas izvilināšana no latentā rezervuāra, veicot nabas un kaulu smadzeņu cilmes šūnu transplantāciju.
HIV latentais rezervuārs – tā ir inficēto šūnu "gulošā" grupa, kas turpina vīrusa izplatīšanu pa organismu, bet ko nav iespējams atklāt un kuru nevar izārstēt ne preparāti, ne cilvēka imūnsistēma.
Seši pacienti turpina lietot antiretrovīrusu preparātus, taču zinātnieki pieļauj, ka viņu organismi ir pilnībā atbrīvojušies no vīrusa.
Līdz šim HIV bija iespējams tikai nomākt ar antiretrovīrusu terapiju, kas ļāva inficētajiem dzīvot normālu dzīvesveidu.
Par pētījuma pamatu kļuva "Berlīnes pacients".
Spāņu zinātnieku aprakstītā terapija balstās uz amerikāņa Timotija Brauna gadījumu. Viņu uzskata par vienīgo cilvēku pasauē, kuram izdevies izāsrēties no HIV.
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Source: Annals of Internal Medicine | ORIGINAL RESEARCH | 16 OCTOBER 2018 | «Mechanisms That Contribute to a Profound Reduction of the HIV-1 Reservoir After Allogeneic Stem Cell Transplant» | http://annals.org/aim/article-abstract/2707334/mechanisms-contribute-profound-reduction-hiv-1-reservoir-after-allogeneic-stem |
<... Background:
The multifactorial mechanisms associated with radical reductions in HIV-1 reservoirs after allogeneic hematopoietic stem cell transplant (allo-HSCT), including a case of HIV cure, are not fully understood.
Objective:
To investigate the mechanism of HIV-1 eradication associated with allo-HSCT.
Design:
Nested case series within the IciStem observational cohort.
Setting:
Multicenter European study.
Participants:
6 HIV-infected, antiretroviral-treated participants who survived more than 2 years after allo-HSCT with CCR5 wild-type donor cells.
Measurements:
HIV DNA analysis, HIV RNA analysis, and quantitative viral outgrowth assay were performed in blood, and HIV DNA was also measured in lymph nodes, ilea, bone marrow, and cerebrospinal fluid. A humanized mouse model was used for in vivo detection of the replication-competent blood cell reservoir. HIV-specific antibodies were measured in plasma.
Results:
Analysis of the viral reservoir showed that 5 of 6 participants had full donor chimera in T cells within the first year after transplant, undetectable proviral HIV DNA in blood and tissue, and undetectable replication-competent virus (<0.006 infectious unit per million cells). The only participant with detectable virus received cord blood stem cells with an antithymocyte globulin–containing conditioning regimen, did not develop graft-versus-host disease, and had delayed complete standard chimerism in T cells (18 months) with mixed ultrasensitive chimera. Adoptive transfer of peripheral CD4+ T cells to immunosuppressed mice resulted in no viral rebound. HIV antibody levels decreased over time, with 1 case of seroreversion. ...>