Scientists say a man with HIV is the first to reach long-term remission without a bone marrow transplant, but their peers are skeptical
- At a virtual medical conference, researchers announced that a 36-year-old man from Brazil was HIV-free, after being given a cocktail of drugs.
- Their peers were skeptical, noting that HIV tended to go away and then return in patients who had been touted as cured.
- The researchers announced that they would send samples of the man's blood to other labs to be independently tested.
Brazilian researchers announced that a 36-year-old man in Brazil is HIV-free after receiving a cocktail of antiviral drugs.
If true, this unidentified case, detailed at the medical conference AIDS 2020, would be the first instance of long-term remission from HIV without a stem cell or bone marrow transplant.
But the researchers' peers are skeptical, since anti-retroviral therapy, which is used to queel HIV and prevent it from developing into AIDS, has been the standard treatment for all HIV-positive people since the treatment was invented in 1995.
"There will be a lot of buzz, a lot of controversy about this part — everyone's going to be skeptical," HIV researcher Dr. Steve Deeks told the New York Times. "Am I skeptical? Of course. Am I intrigued? Absolutely."
According to the research team at the Federal University of São Paulo, the man was diagnosed with HIV in 2012 and began taking the typical antiretroviral drugs.
In 2016, he joined a clinical trial where he was given three additional drugs, including maraviroc and nicotinamide, for 11 months, in an aggressive treatment designed to flush the virus out of his body.
The man returned to the standard anti-retroviral therapy after the trial ended, and stopped taking all anti-retroviral drugs in March 2019. Every three weeks since March 2019, his blood has been tested.
The fact that he tested negative for HIV is not remarkable in itself — anyone religiously taking anti-retroviral therapy for more than six months will reach an "undetectable" viral load.
But in this case, the researchers said they found no trace of dormant HIV-infected cells in his system. These latent cells can become active as soon as treatment stops, making people sick again.
The researchers announced that virus-detecting blood tests did not show any remaining traces of HIV in the man's blood. The man also did not show any signs of having antibodies to the virus.
Two people in history have been cured of HIV
Prior to this, just two people had been cured of HIV.
First was "the Berlin Patient," an American man named Timothy Ray Brown, who received a bone marrow transplant in 2007 in Berlin, Germany.
Brown had leukemia, and required a bone marrow transplant to survive. His doctors sought bone marrow from someone with an HIV-resistant gene. Post-transplant, Brown suffered a series of health issues, he needed to be put in a medically induced coma, and nearly died. But not only was his cancer gone, so was his HIV. He is still alive today, with no HIV, and no need for the anti-retroviral therapy that HIV-positive people must take habitually.
In 2019, "the London Patient," a man named Adam Castillejo, became the second person ever to enter long-term remission from HIV. Castillejo, who was treated in London, England, had two bone marrow transplants. His recovery process was less intense, assuaging scientists' concerns that Brown had only been cured because of the massive destruction to his immune system, which also rid him of HIV.
Scientists are urging caution
Deeks said that independent lab results will be needed to confirm these results. The Brazilian research team has offered to send the man's blood samples to other labs.
When HIV enters the body, it inserts genetic material into the DNA of its host's immune cells. This forces the cells to make copies of the virus. Some active HIV-infected cells are created, and some latent HIV-infected cells are created. These cells are infected with HIV but are not actively producing new HIV, according to the NIH.
But there is a difference between testing negative for HIV, as some people do after taking medication that makes their HIV undetectable, and having zero traces of HIV in your RNA or DNA. In the first instance the virus is controlled within the body, but in the second instance it is entirely removed from the body.
Many researchers have announced they've cured HIV in their patients, only for the disease to return a short while later.
A baby in Mississippi stopped taking antiretroviral medication at 18 months, researchers eagerly announced that the virus was gone, and then two years later, in 2014, researchers detected HIV in the child again. In 2013, two Boston patients received bone marrow transplants, and headlines declared that they had been cured, only for the virus to resurface again.
The São Paulo Patient has gone 66 weeks without showing signs of the virus.
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