Is HIV Infection Really Cured?
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Abstract
Infection with the human immunodeficiency virus (HIV) requires the presence of CD4 receptors and chemokine receptors. Two of the most principal chemokine receptors are C-C chemokine receptor 5 (CCR5) and/or the chemokine (C-X-C motif) receptor 4 (CXCR4). Homozygosity of a 32-bp deletion in the CCR5 allele provides resistance against the cellular entry of CCR5-tropic HIV strains. The successful long-term control of HIV by allogeneic haematopoietic stem cell transplantations (allo-HSCT) from a donor who was homozygous for CCR5 delta32, had been documented as a "Berlin patient" and a "London patient". They bothhad remained without viral recrudescence after transplantation and discontinuation of antiretroviral therapy. However, a wide application of allo-HSCT from donors with homozygous CCR5 delta32 mutation for HIV remission is still quite challenging so far under the condition of a low percentage of homozygous CCR5 delta32 mutation, high risk of allo-HSCT, HIV tropism shift after HSCT, and huge expense. Although the "Berlin patient" and the "London patient" take a new hope to control HIV infection, it is still too early to conclude that the "cure" of HIV infection has been achieved.
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