South Africa is in dire need of a public umbilical cord blood stem cell bank (UCB SCB). A severe shortage of genetically compatible samples for BM transplantation precludes the majority of South Africans from receiving the relevant medical care. UCB is a viable alternative to BM but is currently disposed of post-delivery. UCB could furthermore serve as a resource of genetically compatible haematopoietic progenitor cells (HPCs) that could be used in gene therapy approaches directed towards a cure for HIV-1. Knowing whether HIV-1 affects or infects primitive HPCs is vital to determine the course of action for transplantation of UCB-derived genetically resistant HPCs. Collecting and storing UCB in a public UCB bank could thus serve as a vital resource of genetically compatible samples for BM transplantation. It was thought that the high incidence of HIV-1 in South African patients and the persistent stigma surrounding HIV-1 would be problematic for collecting sustainable numbers of UCB units and subjecting units to compulsory screening for infectious diseases. This was however, not the case. In the South African context, we are faced with unique and rich challenges relating to cultural and religious differences that are further augmented by linguistic constraints and educational insufficiencies. Nevertheless, the majority of patients within the interviewed patient cohort were supportive of the idea of establishing a public UCB SCB in SA and were willing to undergo additional HIV-1 screening. The Ultrio-Plus® assay was verified in this study for screening UCB units for HIV-1 and could be used in routine analyses of UCB units prior to banking. Conflicting results in the literature exist with regard to HIV-1’s ability to infect or affect haematopoietic progenitor cells. Results from this study revealed that HIV-1 was not only able to affect HPCs’ ability to form colonies in vitro, but was also capable of infecting CD34+ HPCs in some individuals. These results substantiate the theory that some CD34+ HPCs serve as viral reservoirs which could account for residual viraemia in patients on antiretroviral therapy. Results suggest that allogeneic transplantation of HIV-1 infected individuals with UCB-derived, genetically modified HPCs, should be pursued. / Thesis (PhD)--University of Pretoria, 2012. / Immunology / unrestricted

Qualificar as primeiras unidades de Sangue de Cordão Umbilical e Placentá- rio (SCUP) criopreservadas no Banco de Sangue Umbilical e placentário da Fundação de Hematologia e Hemoterapia de Pernambuco (BSCUP/HEMOPE), no período de dezembro de 2014 a junho de 2017. Justificativa: O sangue do cordão é rico em células progenitoras hematopoéticas (CPH), utilizado para transplante e tratamento de patologias benignas e malignas. Avaliar as primeiras unidades coletadas no BSCUP/ HEMOPE será de grande valia para sua caracterização, planejamento de ações de melhoria do processo, contribuindo para o aumento da eficácia dos transplantes. Métodos: Foram triadas gestantes sem histórico de diagnóstico para doenças transmissíveis pelo sangue, com gestação terminada em recém-nascido (RN) vivo; caracterizadas através das variáveis sociodemográficas: idade, idade gestacional, antecedentes obstétricos e cor da pele dos RN foram caracterizados pelas variáveis explicativas: Gênero e Peso; as amostras das mães foram coletadas no dia do parto ou em até 48h após. O tempo entre o término da coleta e o início da criopreservação da unidade das CPH não excedeu 48 horas. As unidades de SCUP foram avaliadas quanto ao volume, total de células nucleadas (TCN), quantificação de células CD 34+, contagem de eritroblastos viabilidade celular e contaminação microbiológica. Neste estudo foi avaliada a variável \"unidades adequadas ao uso em relação ao peso do receptor, tomando com o base o TCN e o peso de um provável receptor, assim categorizados: unidades <12,5 x10e8 para peso 12,5 para peso >50kg; Resultados: Volume Inicial (ml):(min.50,0; max.166,80); Volume final(mL): (min.19,07;max.21,75); TCN pré (x108): (min.6,0;max.27,80);TCN pós(x108): (min.5,0; max.22,6); Recuperação Celular (%): (min.0,67; max.39,50); CD34+(x106):(min.0,67;max.39,50);Viabilidade(%): (min.71,35max.100); Conclusão: Das 113 unidades armazenadas, 89 (78,76%) atendem a receptores < 50kg (crianças) e 24 (21,24%) atendem a receptores >50k (adultos). O inventário apresentou resultados em conformidades com o especificado na legislação vigente, portanto, qualificadas para atender à demanda transfusional de transplantes de CPH. / To qualify the first units of cryopreserved Umbilical Cord and Placental Blood (SCUP) in the Umbilical and Placental Blood Bank of the Hematology and Hemotherapy Foundation of the State of Pernambuco (BSCUP / HEMOPE), from December 2014 to June 2017 Rationale: Cord blood is rich in hematopoietic progenitor cells (HPC), used for transplantation and treatment of benign and malignant pathologies. Evaluating the first units collected in the BSCUP / HEMOPE will be of great value for its characterization, planning of actions to improve the process, contributing to increase the efficiency of transplants. Methods: Pregnant women with no history of diagnosis for blood-borne diseases were screened, with gestation terminated in live newborn (NB); characterized by the sociodemographic variables: age, gestational age, obstetric history and skin color, NB were characterized by the explanatory variables: Gender and Weight; the samples of the mothers were collected on the day of delivery or within 48 hours after delivery. The time between the end of the collection and the beginning of the cryopreservation of the MHC unit did not exceed 48 hours. SCUP units were evaluated for volume, total nucleated cells (TNC), CD34 + cell count, cell viability erythroblast counts, and microbiological contamination. In this study, the variable \"units suitable for use in relation to the weight of the receptor\" was evaluated, taking as base the TNC and the weight of a probable receiver, as follows: units <12.5 x10e8 for weight 12 , 5 for weight> 50 kg; Results: Initial volume (ml): (min.50.0, max.166.80); Final volume (mL): (min.19.07, max.21.75); TCN pre (x108): (min.6,0; max.27,80); TCN post (x108): (min.5,0; max.22,6); Cellular Recovery (%): (min.0.67, max.39,50); CD34 + (x106): (min.0.67, max.39.50); Viability (%): (min.71,35max.100); : Of the 113 stored units, 89 (78.76%) attend to receptors <50kg (children) and 24 (21.24%) attend receptors> 50k (adults). Conclusion: The inventory presented results in compliance with that specified in current legislation, therefore, qualified to meet the transfusional demand for HPC transplants.