Successful treatment of human immunodeficiency virus infection may ultimately require targeting of hematopoietic stem cells. Here we used retroviral vectors carrying the ribozyme gene to transduce CD34+ cells from human fetal cord blood. Transduction and ribozyme expression had no apparent adverse effect on cell differentiation and/or proliferation. The macrophage-like cells, differentiated from the stem/progenitor cells in vitro, expressed the ribozyme gene and resisted infection by a macrophage tropic human immunodeficiency virus type 1. These results suggest the feasibility of stem cell gene therapy for human immunodeficiency virus-infected patients.Moloney murine leukemia virus long-terminal repeat (LTR) promoter was inefficient or completely turned off in the transduced stem cells upon maturation. In this study, we largely followed the previous protocols for enrichment of CD34+ cells and for retroviral transduction (7). We report here studies using retrovirus vectors carrying the ribozyme gene driven by two different polymerase III promoters to transduce CD34+ hematopoietic stem/progenitor cells isolated from fetal cord blood and then challenging the progeny cells with a macrophage tropic strain of HIV-1. The experimental results show the in vitro efficacy of using stem/progenitor cells as the target for gene therapy for the treatment of HIV infection.When the concept of "intracellular immunization" was first introduced as a gene therapy approach for the treatment of human immunodeficiency virus (HIV)/AIDS in 1988 (1), it was proposed that gene transfer into hematopoietic stem cells would be a preferred strategy to achieve sustained immune reconstitution. Stem cells possess both the capacity for selfrenewal and the ability to give rise to all hematopoietic cell lineages, including brain macrophage and microglial cells, which are also targets for HIV infection. Autologous or allogeneic transplantation with transduced stem cells might thus allow the permanent repopulation of all hematopoietic cell lineages of the immune system with "intracellularly immunized" cells (2). We have previously reported that a hairpin ribozyme designed to cleave HIV-1 RNA in the 5' leader sequence suppressed virus expression in HeLa cells cotransfected with proviral DNAs (3, 4). More recently, we showed that human T-cell lines (5) and primary T cells (6) transduced with retroviral vectors containing this ribozyme were resistant to challenge with diverse strains of HIV, including several uncloned clinical isolates.Transduction and expression of transgenes in bone marrow cells were hampered by the paucity of stem cells in normal bone marrow and by the inefficiency of most methods of gene transfer. Ho and colleagues (7) used immunomagnetic beads to enrich for CD34+ cells from bone marrow, mobilized peripheral blood, and fetal cord blood. A purity of 85%-95% of CD34+ cells was routinely obtained by using this procedure (7). Moreover, the isolated CD34+ cells were highly susceptible to retroviral vector-mediated gene transfer: u...