10 Mar, 14 | by BMJ
NEJM 6 Mar 2014 Vol 370
901 The cat and mouse game of man versus human immunodeficiency virus has just taken a new turn. HIV kills off CD4 T cells by binding to the CCR5 receptor. Now if you could manufacture CD4 T cells without a functioning CCR5 receptor, the virus would not be able to bind to them, and might go into a sulk. You would need billions of these T lymphocytes, of course, and they might need topping up from time to time. This seems to be what happened in an experiment on 12 volunteers with HIV who stopped their antiretroviral treatment four weeks after the infusion of 10 billion autologous CD4 T cells, 11 to 28% of which were genetically modified to switch off the receptor. The modified cells had an estimated mean half-life of 48 weeks. As hoped, they proved resilient against HIV: the details are complex, but this approach seems worth a lot more enquiry.