HIV and Stem Cell Transplantation

  • Ignacio A. Echenique
  • George E. Nelson
  • Valentina Stosor
  • Christine M. Durand
Transplant and Oncology (M Ison, Section Editor)

DOI: 10.1007/s11908-014-0424-y

Cite this article as:
Echenique, I.A., Nelson, G.E., Stosor, V. et al. Curr Infect Dis Rep (2014) 16: 424. doi:10.1007/s11908-014-0424-y
Part of the following topical collections:
  1. Topical Collection on Transplant and Oncology

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.

Keywords

AIDSAllogeneic stem cell transplantationAntiretroviral therapyAutologous stem cell transplantationBone marrow transplantationGVHDHIVHIV cureHIV eradicationHIV reservoirHodgkin lymphomaNon-Hodgkin lymphomaStem cell transplantation

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

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Ignacio A. Echenique
    • 1
  • George E. Nelson
    • 3
  • Valentina Stosor
    • 1
    • 2
  • Christine M. Durand
    • 3
    • 4
  1. 1.Division of Infectious Diseases, Department of MedicineNorthwestern University Feinberg School of MedicineChicagoUSA
  2. 2.Division of Organ Transplantation, Department of SurgeryNorthwestern University Feinberg School of MedicineChicagoUSA
  3. 3.Division of Infectious Diseases, Department of MedicineJohns Hopkins School of MedicineBaltimoreUSA
  4. 4.Division of Infectious DiseasesJohns Hopkins School of MedicineBaltimoreUSA