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CD4-zeta gene-modified T lymphocytes represent a pioneering form of first-generation chimeric antigen receptor (CAR) T-cell therapy designed to treat HIV-1 infection. The therapeutic construct consists of autologous T cells genetically engineered to express a chimeric receptor comprising the extracellular domain of the human **CD4 molecule** fused to the intracellular signaling domain of the **CD3-zeta chain** of the T-cell receptor complex. By utilizing the natural affinity of CD4 for the HIV-1 envelope glycoprotein **gp120**, these modified T cells are redirected to recognize and eliminate HIV-infected cells in an MHC-independent manner. Initially developed in the 1990s, most notably by **Cell Genesys**, this therapy demonstrated an excellent safety profile and remarkable long-term persistence (up to a decade) in clinical trials. However, despite these properties, it failed to significantly reduce the latent viral reservoir or provide a durable cure as a monotherapy, leading to a shift in research toward second-generation CARs and combination approaches.
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