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Altered Immune Reconstitution in Allogeneic Stem Cell Transplant Recipients With Human Immunodeficiency Virus (HIV)

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  • Daniel D Murray
  • John Zaunders
  • Samuel T Milliken
  • C Mee Ling Munier
  • Carole Ford
  • C Orla Morrissey
  • Malini Visweswaran
  • Sharon Avery
  • Joseph Sasadeusz
  • John Kwan
  • Shrinivas Desai
  • Matthew Law
  • Kersten K Koelsch
  • Sharon R Lewin
  • John Moore
  • Anthony D Kelleher
  • Mark N Polizzotto
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BACKGROUND: Persons living with human immunodeficiency virus (HIV) are at elevated risk of developing the malignant diseases that require allogeneic stem cell transplantation (ASCT). Recent data suggest that these individuals are also at an elevated risk of certain complications post-ASCT. This risk may result from preexisting HIV-related factors affecting dynamics of immune reconstitution post-ASCT. However, to date, there has been little work describing the dynamics of immune reconstitution post-ASCT in persons with HIV and none comparing these data to controls without HIV.

METHODS: We assessed T-cell reconstitution in 6 ASCT with HIV recipients (HIV+ASCT) compared to a control population of 21 ASCT without HIV recipients. In a subset of HIV+ASCT recipients we performed additional flow cytometry profiling of CD8+ T-cell subsets and antigen specificity of reconstituting CD4+ and CD8+ T cells.

RESULTS: We observe no difference in post-ASCT CD4+ T cells between HIV+ASCT and HIV-negative ASCT recipients, despite much lower pre-ASCT CD4+ T-cell counts in the HIV+ASCT group. In contrast, we observed significantly higher CD8+ T-cell numbers in the HIV+ASCT group post-ASCT. The reconstituting CD8+ T-cells were predominantly CD45RO+, whereas homing markers and antigen specificity of these cells varied between participants.

CONCLUSION: This study represents the most extensive characterization of immune-reconstitution post-ASCT in persons with HIV, and the first to our knowledge to compare these data to ASCT controls without HIV. The results indicate that immune reconstitution in this group can be affected by preexisting HIV infection and post-ASCT antigen exposure.

Original languageEnglish
JournalClinical infectious diseases : an official publication of the Infectious Diseases Society of America
Issue number7
Pages (from-to)1141-1146
Number of pages6
Publication statusPublished - 8 Apr 2021
Externally publishedYes

    Research areas

  • acute leukemia, allogeneic stem cell transplant, HIV, immune reconstitution, lymphoma

ID: 60546178