Ethics of ART interruption after stem-cell transplantation

Abstract

In the wake of reports of an HIV cure for Timothy Brown (the Berlin patient) after two haemopoietic stem cell transplantations (HSCT) from a donor homozygous for the CCR5Δ32 mutation, at least four other individuals have had antiretroviral therapy (ART) stopped as analytical treatment interruptions after similar procedures. Only one of those patients received stem cells from a donor homozygous for CCR5Δ32, and three of the recipients were heterozygous for CCR5Δ32. The clinical outcome after each of these interruptions has been disappointing, with pronounced viral rebound and associated morbidity. What if remission among a minority of patients is possible after HSCT, such as that experienc..