{"id":4223,"date":"2025-08-17T01:38:51","date_gmt":"2025-08-16T20:08:51","guid":{"rendered":"https:\/\/regisdigitals.com\/client\/Sunact\/?p=4223"},"modified":"2025-10-27T21:53:02","modified_gmt":"2025-10-27T16:23:02","slug":"car-t-cell-therapy-in-people-living-with-hiv-aids-plha","status":"publish","type":"post","link":"https:\/\/regisdigitals.com\/client\/Sunact\/car-t-cell-therapy-in-people-living-with-hiv-aids-plha\/","title":{"rendered":"CAR T-cell Therapy in People Living with HIV\/AIDS (PLHA)"},"content":{"rendered":"\t\t
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17 August 2025<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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Introduction<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Cancer care is evolving quickly, and CAR T – cell therapy is one of the most important advances. In this treatment, a person\u2019s own immune cells (T-cells) are collected, engineered in a lab to better recognise cancer, and then infused back to attack it. People living with HIV\/AIDS (PLHA) can develop blood cancers like diffuse large B\u2011cell lymphoma (DLBCL). Although PLHA were excluded from the original approval trials for CAR T, growing real\u2011world experience shows that CAR-T can be safe and effective for selected PLHA when HIV is well controlled and care is coordinated by an experienced team.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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HIV-related cancers becoming targets for CAR\u2011T<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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CD19\u2011directed CAR\u2011T therapy has changed outcomes for patients with certain B\u2011cell lymphomas after standard treatments fail. Increasingly, PLHA with relapsed or refractory DLBCL have been treated with CD19 CAR\u2011T when on stable antiretroviral therapy (ART), with low or undetectable viral loads. These reports show that T\u2011cells from PLHA can be collected and engineered, and that the therapy can control lymphoma. Researchers are also exploring future approaches that may one day target both lymphoma and HIV, though these remain experimental.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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Caveats, controversies, and practical issues<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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  • Limited trial data: Because PLHA were not included in pivotal studies, most evidence comes from case reports and small series. The early signal is encouraging but still limited.<\/span><\/li>
  • Manufacturing feasibility: Successful leukapheresis and CAR\u2011T production have been reported while patients continued ART, without special holds or extra safety steps.<\/span><\/li>
  • Platform choice: Most published cases used a gamma\u2011retroviral CAR\u2011T product. Lentiviral platforms raise theoretical concerns in PLHA and have less published experience in this specific setting.<\/span><\/li>
  • Drug interactions and infection risk: ART should continue throughout treatment. Coordination with infectious disease specialists helps prevent interactions and maintain viral suppression.<\/span><\/li>
  • Toxicities: Side effects like cytokine release syndrome (CRS) and immune\u2011cell neurotoxicity (ICANS) occurred at expected rates and were managed with standard treatments such as tocilizumab and steroids.<\/span><\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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    Experience in the literature<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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    • Who was treated: Reported patients were adults with relapsed or refractory DLBCL, often after several prior therapies. Many had undetectable HIV viral loads and CD4 counts commonly around the low\u2011to\u2011mid 100s to 200s.<\/span><\/li>
    • Treatment given: Patients received CD19 CAR\u2011T with standard lymphodepleting chemotherapy (fludarabine and cyclophosphamide), while ART continued without interruption.<\/span><\/li>
    • Outcomes: A majority achieved meaningful responses, including complete and partial remissions. Toxicities were manageable, and there were no reported manufacturing failures.<\/span><\/li>
    • Early registry signal: Interim registry experience suggests feasibility and outcomes broadly comparable to non\u2011HIV populations over early follow\u2011up, though longer\u2011term data are still needed.<\/span><\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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      Recommendations from the literature<\/h3>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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      • Multidisciplinary coordination: Involve oncology, infectious disease, pharmacy, apheresis, and cell therapy teams from the start.<\/span><\/li>
      • Maintain ART: Keep HIV therapy uninterrupted; adjust the regimen only to avoid drug interactions.<\/span><\/li>
      • Infection prevention: Screen for and treat infections before therapy; provide prophylaxis (for example, Pneumocystis and herpesvirus) based on CD4 count and clinical risk.<\/span><\/li>
      • Standard CAR\u2011T pathways: Use routine lymphodepletion and follow established protocols for monitoring and managing CRS\/ICANS.<\/span><\/li>
      • HIV and immune monitoring: Check HIV viral load regularly after infusion, follow CD4\/CD8 recovery, and consider IVIG if infections occur with low antibody levels.<\/span><\/li>
      • Product\/platform selection: Prefer CAR\u2011T platforms with existing experience in PLHA until broader data are available for others.<\/span><\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t
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        - Medically reviewed by Dr. Naveen Vairamoorthy D (Consultant, Clinical Haematology and Bone Marrow Transplant) at SunAct - Advanced Cancer Therapies.<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"

        17 August 2025 Introduction Cancer care is evolving quickly, and CAR T – cell therapy is one of the most important advances. In this treatment, a person\u2019s own immune cells (T-cells) are collected, engineered in a lab to better recognise cancer, and then infused back to attack it. People living with HIV\/AIDS (PLHA) can develop […]<\/p>\n","protected":false},"author":1,"featured_media":4237,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-4223","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog"],"_links":{"self":[{"href":"https:\/\/regisdigitals.com\/client\/Sunact\/wp-json\/wp\/v2\/posts\/4223","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/regisdigitals.com\/client\/Sunact\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/regisdigitals.com\/client\/Sunact\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/regisdigitals.com\/client\/Sunact\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/regisdigitals.com\/client\/Sunact\/wp-json\/wp\/v2\/comments?post=4223"}],"version-history":[{"count":0,"href":"https:\/\/regisdigitals.com\/client\/Sunact\/wp-json\/wp\/v2\/posts\/4223\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/regisdigitals.com\/client\/Sunact\/wp-json\/wp\/v2\/media\/4237"}],"wp:attachment":[{"href":"https:\/\/regisdigitals.com\/client\/Sunact\/wp-json\/wp\/v2\/media?parent=4223"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/regisdigitals.com\/client\/Sunact\/wp-json\/wp\/v2\/categories?post=4223"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/regisdigitals.com\/client\/Sunact\/wp-json\/wp\/v2\/tags?post=4223"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}