"Stem Cell Therapy: An Emerging Boon in the Cure for HIV"

History:

HIV/AIDS the ongoing 40 year debate all over the world is an non-curable disease that interfered the life of infected population. First case of this virus in a human was reported in 1981 more prevalent among the homosexual men.

According to WHO nearly 39 million people are living with HIV. Emerge of antiretroviral therapy(ART) have created an revolution in the treatment of HIV/AIDS but unfortunately fails to cure it.

There emerges ample amount of drugs for antiretroviral therapy. But these are expensive for treatment. 

Mechanism of infection of HIV 

Before going into the topic of discussion let's us know how HIV enters human body and Infects the cells 

HIV Entry Mechanism: HIV binds to CD4 receptors and requires the c-c chemokine receptors-type5 (CCR5) co-receptor to enter T helper cells.

CCR5-Δ32 Mutation: This mutation leads to a lack of functional CCR5 receptors, hindering HIV's ability to infect these cells.

Prevalence: The CCR5-Δ32 mutation is more commonly found in individuals of Northern European descent, but is rare overall.

Stem cell therapy

So there is a emerging Boon for hiv treatment which is stem cell replacement therapy

In which the Stem cell from the donor is received after a series of assessments done on donor such as 

1)HLA Typing (Human Leukocyte Antigen)

2)Blood Tests

3)Medical History and Physical Examination:

4)Blood Type Matching (ABO Compatibility): 

5)Blood Type Matching (ABO Compatibility): 

6)Pregnancy Test(as the donation process could pose risks to both the donor and the fetus.)

7)Chest X-ray and Electrocardiogram 

8)Bone Marrow Aspiration and Biopsy

Transplantation of stem cells:

The stem cell from a donor with the CCR5-Δ32 mutation after a series of laboratory processing is introduced into the individual to be treated. Before the transplant, the patient underwent conditioning therapy (chemotherapy and/or radiation) to destroy their existing immune cells, including the HIV-infected cells.

Engraftment and Repopulation: 

The transplanted HIV-resistant stem cells engrafted in the patients' bone marrow and began to repopulate their immune system with new, HIV-resistant white blood cells. This process replaces the patient's original, HIV-susceptible immune cells with ones that the virus cannot easily infect

Viral Eradication: 

As the new immune cells proliferated and replaced the old ones, the levels of HIV in the patients' bodies decreased dramatically. Since the virus could not infect the new CCR5-Δ32 cells, it struggled to find new hosts, leading to a significant reduction in viral reservoirs and, in these cases, functional cures.

Drawbacks

1) Donor Compatibility: Finding a suitable donor with a close HLA match can be challenging

2) Conditioning Regimen: immunosuppressive making patient vulnerable to infection

3) Graft-versus Host Disease(GVHD):  

Transplanted cells can attack the recipient's body

4) Graft Rejection: 

The recipient's body may reject the transplanted stem cells, leading to engraftment failure 

5) Opportunistic Infections: 

Due to immunosuppression and the conditioning regimen, patients are at a high risk of opportunistic infections

6) Cancer Risks

7) Expensive and limited centers perform human stem cell transplantation

8) Ethical and Psychological Concerns: