The patient, Spain, has not received any type of medication for more than 15 years. However, her viral load is undetectable.
Source: RT in Spanish
A patient from Barcelona, Spain, has had an undetectable HIV viral load for more than 15 years without taking any medication against the virus, after receiving antiretroviral treatment.
This exceptional case of functional cure of HIV was presented on Wednesday at the International AIDS Conference, which is being held in Montreal (Canada), by the Hospital Clínic-Idibaps, the center that worked on its initial treatment and which has been doing follow-up of this anonymous patient.
No personal data is known about her, neither her age nor other physical conditions. What is known about her clinical history is that she was infected with the AIDS virus years ago and was diagnosed during an acute phase of the disease that had to be treated with antiretrovirals for nine months and with various interventions with cyclosporine A, an immunosuppressant. .
This latest case of functional cure sheds new light on the mechanisms by which certain people can control the virus after taking antiretroviral treatment.
▶️ Dr. @NuriaCliment1 and dr. @JMallolas They explain the case in this video ? pic.twitter.com/4LOaPvdMxV
— Hospital CLINIC (@hospitalclinic) July 27, 2022
Over the subsequent 15 years, his viral load has become undetectable, although he continues to have viable HIV in virus reservoirs. During this time, the woman has not received any type of medication and she has become the first patient in the world to present this type of functional healing.
a unique case
Acquired Immunodeficiency Syndrome (AIDS) is the most serious form of infection by the Human Immunodeficiency Virus (HIV); however, current treatments have managed to make the disease chronic and improve the quality of life of patients.
Antiretroviral therapy is effective in suppressing viral replication, but the virus persists in reservoirs and usually recovers after discontinuation of therapy. However, there are a few people who maintain undetectable viral loads without taking medication. They are known as aftertreatment controllers.
Other cases of cure are related to bone marrow transplantation, either in patients who have defective viruses or in patients with genetic factors that provoke a powerful immune response against HIV from a type of lymphocyte, CD8+ cells. These latter patients are called elite controllers.
However, the case of this woman is different. “The patient did not have classic genetic factors associated with HIV control, she was not an elite controller of the disease and even more, she presented a severe primary infection, something that is not common in post-treatment controllers either,” says Josep M. Miró , specialist in infectious diseases at the Hospital Clínic and professor of Medicine at the University of Barcelona.
Likewise, it has also been verified that the woman is not infected by defective viruses. “Over these years we have found a pronounced and progressive drop in the number of viruses in the reservoir, which suggests control by the immune response,” adds researcher Sonsoles Sánchez-Palomino.
The key: natural killer cells and CD8+ T lymphocytes
The research carried out during these years confirmed that the patient’s blood cells were highly resistant to being infected by the virus in in vitro cultures, but that her purified CD4+ T lymphocytes were susceptible to infection. This suggests that other cell populations in the blood were blocking infection and helping to control HIV.
“The great novelty of the work is that we have characterized the cells that gain control of the virus,” says Núria Climent, the researcher of the group that has led the communication at the congress. Thus, the trial has shown that the inhibition of HIV is promoted by two types of lymphocytes: natural killer (NK) cells, which are part of the innate immune system; and CD8+ T lymphocytes, key to the defense of cells against viruses and bacteria.
The patient studied has very high levels of these two types of cells, which are believed to act by blocking the virus or destroying infected cells.
“The case presented is exceptional, not only because there are very few people with long-term post-treatment control, but also because of the mechanism of HIV control, different from that described in elite controller patients and other cases documented so far”, concludes Josep Mallolas. , head of the HIV Unit at the Clinic and professor at the Department of Medicine at the UB.
