It is about a patient who, without any type of antiretroviral drug, managed to absolutely control the replication of HIV (human immunodeficiency virus) in her body, maintaining an undetectable viral load for more than 15 years.
The case was recently presented by the Clínic-IDIBAPS Hospital during the 24th edition of the International AIDS Conference 2022, which takes place from July 29, 2022 to August 2 of the same year.
In a press release from Official page from the hospital describe this event as a unique and exceptional case of long-term functional recovery. As we all know there is no cure for HIV, however, there are currently antiretroviral therapies that effectively control the replication of the virus in your body.
Next, How was control achieved in this case without the help of antiretrovirals?
The woman was detected as a carrier of HIV in 2006, at a stage called acute infection, which is the earliest stage of infection with this virus, which reproduces rapidly and spreads throughout the body.
After that, the patient was included in a clinical trial which consisted of evaluating the use of antiretroviral therapy in combination with immunomodulatory treatments such as cyclosporine A, the duration of the intervention was 9 months.
It brightens in report by Josep Mallolas, specialist in infectious diseases at the Hospital Clínic, and head of the IDIBAPS group that “The patient did not have classic genetic factors associated with the control of HIV, she was not an elite in the control of the disease and moreover, she presented with a serious primary infection, which is not usual among post-treatment monitors.” Moreover, it was found that the patient was not infected with defective viruses.
Given: Elite controllers refer to patients who have a strong immune response to HIV mediated by a specific type of lymphocyte, CD8+ T cells.
All of the considerations mentioned in the previous paragraph constitute characteristics that cause patients to maintain undetectable viral loads without taking medication, however, none of the circumstances were the case for the patient described here.
The evaluations carried out before, during and after the treatment made it possible to detect that after the established period of 9 months, during which the induced therapy was stopped, the patient was able to reduce her viral load until she was undetectable and, above all of all, which has been constant for more than 15 years.
Make way for what is called “functional recovery”, which refers to the fact that the virus may not be completely eliminated from the body, but does not require antiretroviral treatment because the immune system manages to autonomously control replication efficiently.
Apart from what was described above, another problem that was surprisingly achieved was to characterize the patient’s immune cells that are involved in her control of HIV. As is well known, this virus attacks the immune system by progressively destroying CD4 cells, which considerably decreases the body’s protection.
What they found in the patient’s blood cells was that CD4 cells were still very susceptible to infection, however, immune cells known as “natural killers” and “CD8+ T cells “provide very strong inhibition of HIV in women which together make it possible to block and control its replication.
In this way, Núria Climent, researcher of the study, describes that “the patient has very high levels of these two cells that could block the virus or destroy the infected cells, thus achieving a functional cure”.
Finally, the importance of this exceptional case is that it allowed us to discover another mechanism of long-term post-treatment HIV control that had not been described until now, as well as to characterize what is passes into the immune system, which together could allow new HIV treatment strategies to be devised.
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