So we know that the recent discovery Jonah Sacha m
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So we know that the recent discovery Jonah Sacha made using bNAbs, ART and leronlimab led to the non-development of any reservoirs of HIV despite HIV inoculation. It also led to the eradication of HIV for 1.25 years following inoculation.
My question is regarding LATCH. The patients slated for this protocol would have failed ART and so have developed a significant reservoir of HIV. Would a stem cell transplant eradicate the reservoir in the recipient patient?
How would the same be achieved using AAV?
In LATCH the patients would not have to have failed ART treatment. Of course reservoirs exist whether or not ART has failed. Reservoirs are not eradicated by stem cell transplants but they seem to be lowered. My theory is that reservoirs release HIV in response to lowered active HIV in the body, as far as I know that has never been tested. It would explain how maraviroc and by extension leronlimab decreases the number of reservoirs.
In stem cell transplants involving CCR5 double allele 32 delta deletion donors and in some cases single allele the patients original immune system is wiped out and is replaced by the donors CCR5 deletion genetics. There would be no active HIV reproduction due to lack of expressed CCR5 or in the case of leronlimab by blockade. This gives the immune system the chance to kill off the relatively few HIV viruses released from reservoirs.
The only difference between subcutaneous leronlimab and AAV is that no lapses in coverage would be due to missed or misapplied injections (possibly the cause of HIV viral rebounds in trials) and AAV leronlimab levels may surpass 750mg which would still provide 100% receptor binding in the case of a sharp rise in CCR5 expression due to other immune challenges.