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C34-CXCR4-modified autologous CD4+ T-cells represent an investigational ex vivo gene therapy designed to create HIV-resistant immune cells for patients with HIV-1 infection. The therapy involves the extraction of a patient's own CD4+ T-cells, which are then transduced with a lentiviral vector encoding a chimeric protein. This protein consists of a C34 peptide—a potent HIV-1 fusion inhibitor derived from the heptad repeat 2 (HR2) region of the HIV-1 gp41 envelope protein—fused to the N-terminus of the human CXCR4 co-receptor. By anchoring the inhibitor directly to the cell surface co-receptor used by X4-tropic HIV strains, the modification effectively blocks viral fusion and entry into the cell. This approach aims to provide a protected reservoir of CD4+ T-cells that can survive and maintain immune function despite the presence of circulating virus, potentially addressing both R5- and X4-tropic HIV-1 strains.
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