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HIV and Stem Cell Transplantation

  • Transplant and Oncology (M Ison, Section Editor)
  • Published:
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Abstract

In human immunodeficiency virus (HIV)-infected persons, the incidence of hematologic malignancies, including leukemia and lymphoma, is increased despite the use of successful antiretroviral therapy. Hematopoietic stem cell transplantation (SCT) is emerging as a safe and effective therapy for HIV-infected persons with hematologic malignancies. Management of these patients is complicated by drug–drug interactions involving antiretroviral therapy (ART) that may impact conditioning agent efficacy and metabolism of immunosuppressive medications and potentiate drug toxicities. As such, optimal strategies for ART remain controversial. We discuss recent advances, controversies, and future directions related to SCT in HIV-infected persons, including the investigation of allogeneic SCT as a strategy for HIV cure.

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Abbreviations

AIDS:

Acquired immunodeficiency syndrome

ADM:

AIDS-defining malignancies

alloSCT:

Allogeneic stem cell transplantation

autoSCT:

Autologous stem cell transplantation

CNI:

Calcineurin inhibitor

CFAR:

Center for AIDS Research

CCR5:

Chemokine receptor 5

ART:

Combination antiretroviral therapy

CBT:

Cord blood transplant

CHOP:

Cyclophosphamide, doxorubicin, vincristine and prednisone

CyA:

Cyclosporine

CYP450:

Cytochrome p450

HL:

Hodgkin lymphoma

INSTI:

Integrase Strand Transfer inhibitor

KS:

Kaposi sarcoma

mTOR:

Mammalian target of rapamycin

NADM:

Non-AIDS-defining malignancies

NHL:

Non-Hodgkin lymphoma

NNRTI:

Non-nucleoside reverse transcriptase inhibitor

NRTI:

Nucleoside or nucleotide analogue reverse transcriptase inhibitor

PI:

Protease inhibitor

SIR:

Standardized incidence ratio

SCT:

Stem cell transplantation

SEER:

Surveillance, Epidemiology, and End Results Program registry

TAC:

Tacrolimus

UDP-1A:

Uridine diphosphate glucuronyltransferase-1A

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Acknowledgments

We would like to thank Dr. Richard F. Ambinder for his careful reading of the manuscript.

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Conflict of Interest

Christine Durand, Ignacio Echenique, and George Nelson declare no conflicts of interest. Valentina Stosor has received a grant from NIH/NIAID.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by the authors.

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Authors and Affiliations

  1. Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, 645 N. Michigan Ave, Suite 900, Chicago, IL, 60611, USA

    Ignacio A. Echenique & Valentina Stosor

  2. Division of Organ Transplantation, Department of Surgery, Northwestern University Feinberg School of Medicine, 645 N. Michigan Ave, Suite 900, Chicago, IL, 60611, USA

    Valentina Stosor

  3. Division of Infectious Diseases, Department of Medicine, Johns Hopkins School of Medicine, 1830 E. Monument Street, Suite 450B, Baltimore, MD, 21287, USA

    George E. Nelson & Christine M. Durand

  4. Division of Infectious Diseases, Johns Hopkins School of Medicine, Miller Research Building, Room 869, 733 North Broadway Street, Baltimore, MD, 21204, USA

    Christine M. Durand

Authors
  1. Ignacio A. Echenique
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  2. George E. Nelson
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  3. Valentina Stosor
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  4. Christine M. Durand
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Corresponding author

Correspondence to Christine M. Durand.

Additional information

This article is part of the Topical Collection on Transplant and Oncology

Ignacio A. Echenique and George E. Nelson these authors contributed equally to the work

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Echenique, I.A., Nelson, G.E., Stosor, V. et al. HIV and Stem Cell Transplantation. Curr Infect Dis Rep 16, 424 (2014). https://doi.org/10.1007/s11908-014-0424-y

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  • DOI: https://doi.org/10.1007/s11908-014-0424-y

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