SYNGENEIC ADOPTIVE TRANSFER OF ANTI-HUMAN IMMUNODEFICIENCY VIRUS-1 (HIV-1)-PRIMED LYMPHOCYTES FROM A VACCINATED HIV-SERONEGATIVE INDIVIDUALTO HIS HIV-1-INFECTED IDENTICAL TWIN

Immunotherapy by adoptive transfer of lymphocytes was attempted in ide ntical twins, one who was virus-free and the other who was infected wi th human immunodeficiency virus-1 (HIV-1), at the stage of acquired im munodeficiency syndrome. The noninfected twin was vaccinated by primin g with a recombinant vaccinia virus expressing the envelope glycoprote in of one of his brother's viruses and boosting with the same purified gp160 adsorbed on alum. Vaccination elicited major histocompatibility complex class I-restricted CD8(+) cytolytic T lymphocytes specific fo r HIV-1, but no antibody response. The diseased brother, a 38-year-old homesexual who had developed repeated opportunistic infections since 1990 and had a CD4(+) count reduced to practically zero, was treated b y infusions of lymphocytes collected from the vaccinated brother by ly mphopheresis. After a first transfer of the whole lymphocyte populatio n, no changes were observed in the clinical status and biologic or vir ologic parameters. A second transfer was then applied with activation of the cells with purified envelope glycoprotein before infusion. The outcome of the treatment was an increase in total lymphocytes, in CD4( +) and activated CD8(+) DR(+) cell counts, and in proliferative respon ses to HIV antigens. A marked but transient 3-log increase in cellular and plasmatic virus loads was also observed after the second adoptive transfer. These observations will be considered with attention to imp rove the future adoptive transfer protocols, especially in patients wi th severe CD4(+) depletion. (C) 1994 by The American Society of Hemato logy.