Mesenchymal stem cell therapy in HIV-infected HAART-treated nonimmune responders restores immune competence

Mesenchymal stem cells (MSCs), derived from human umbilical cord or more specifically Wharton’s jelly, in HIV-infected nonimmune responder (NIR) individuals. The NIRs respond to highly active antiretroviral therapy (HAART) and effectively suppress HIV replication, but do not show any improvement in their immune status, as measured by increase in CD4+ T-cell counts. The authors conducted a prospective and open-label controlled pilot clinical trial. They made 3-monthly intravenous MSC transfusions in seven NIRs, whereas six NIRs received saline as controls. All the participants remained on HAART during the study and a 12-month follow-up period. The MSC recipients tolerated the therapy well and showed neither any adverse clinical effect nor increase in viral burden. More importantly, the MSC recipients showed a significant increase in their naive and central memory CD4+ T-cell counts compared with the control group. The therapy also restored their ability to produce interleukin (IL)-2 and IFN-γ in response to HIV antigens, and down-regulated signs of immune activation, immune exhaustion, and inflammation. This study has provided a new glimpse of hope for the HIV-infected NIRs. It is noteworthy that more than 20% HAART-treated HIV-infected persons exhibit the NIR phenotype, and are at increased risk for opportunistic infections, cancer and reduced life expectancy .

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