A patient from Barcelona, ​​the first case in the world to control HIV without treatment

The immunodeficiency syndromehuman science (HIV) is the virus that causes AIDS. It damages your immune system by destroying a type of white blood cell that helps your body fight infections. This puts you at risk for serious infections and certain types of cancer. Although there is no cure for HIV infection, it can be treated with medication, known as antiretroviral therapy. This can turn HIV infection into a manageable chronic disease. It also reduces the risk of transmitting the virus to other people.

Most people living with HIV live long and healthy lives if they receive and continue to take antiretroviral therapy. It is also important that you take care of yourself. Having the support you need, leading a healthy lifestyle and receiving regular medical care can help you enjoy a better quality of life.

A patient from Barcelona, ​​the first case in the world to control HIV without treatment
A patient from Barcelona, ​​the first case in the world to control HIV without treatment

Despite the fact that no cure is known to date, a patient from Barcelona has been controlling HIV for fifteen years without any type of medicine, an exceptional case of functional cure of AIDS that the Hospital Clínic is studying to open new avenues research, aimed at treating to replicate the immune mechanisms of this woman in other infected.

This case, which is presented at the AIDS congress in Montreal (Canada), is different from those known with patients from Berlin and London who were completely cured of AIDS because the virus disappeared after a stem cell transplant for treat the hematological diseases from which they suffered. of.
In the case of the “Barcelona patient” already baptized, it is a functional cure, since the woman still has the virus, but her immune system can completely control the replication fifteen years after having stopped the treatment for AIDS.

More than fifteen years ago, the patient was diagnosed at the stage of acute HIV infection – the earliest – and was included in a clinical trial with antiretroviral treatment for nine months and various interventions with an immunosuppressant, cyclosporin A.

Antiretroviral therapy, the standard for controlling AIDS, is effective in suppressing viral replication in the body and blocking transmission to others, leaving the patient with a blood level of HIV so low that it becomes undetectable in a conventional test. . But HIV persists in reservoirs, so if treatment is stopped, it has the ability to replicate and can attack the patient again. However, a very small group of people, like “the Barcelona patient”, are “post-treatment controllers” and, after stopping the drug, manage to maintain undetectable viral loads.

Other cases of recovery are linked to bone marrow transplants -Berlin and London- or to exceptional cases that have deficient viruses or genetic factors associated with a strong immune response to HIV from a type of lymphocyte, patients who are known as elite controllers

The boss of the Hospital Clínic HIV UnitJosep Mallolas, underlined that the case of Barcelona “is exceptional not only because there are very few people with long-term post-treatment control (fifteen years), but also because of the control mechanism of HIV, different from that described in “elite controller” patients and other cases documented so far”.

In this sense, “the Barcelona patient” does not have classic genetic factors associated with the control of the disease or defective viruses, since the researchers isolated samples in the laboratory and verified that her HIV had the conditions to replicate.

The researchers also confirmed that their T cells – key agents of the immune system – are susceptible to HIV infection, suggesting that other cell populations in the blood block infection and may help control the disease. .

What is new is that the researchers have characterized the two populations of cells that manage to control HIV: natural killer (NK) cells, which are part of the innate immune system and constitute the first line of defense against different pathogens; and CD8+ T cells, which play a key role in defending cells against viruses and bacteria.

“Compared to other people, the patient has very high levels of these two populations that can block the virus and destroy infected cells,” said researcher from the IDIBAPS AIDS group Núria Climent.

Now, the researchers’ objective is to decipher in detail the success model of this patient’s immune system, no details of which have been disclosed at his express request, in order to determine if it is possible to reproduce in others affected, which would be a giant step in controlling the great pandemic of the second half of the 20th century.

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