Scientists from the USA in their new study, published in the journal Nature, reported the first possible case of a cure for the human immunodeficiency virus without a risky bone marrow transplant and even without drugs.
A California resident who contracted HIV in 1992 could become the world’s first patient to recover from the human immunodeficiency virus without a bone marrow transplant or even medication.
“Sustained drug-free control of HIV replication is naturally achieved in fewer than 0.5% of those infected, despite the presence of a replication-competent viral reservoir. Finding this ability to spontaneously maintain undetectable plasma viremia is a major goal of HIV treatment research,” the authors write.
The human immunodeficiency virus is introduced into the genome and forces the mechanisms of the cell to create copies, moreover, it prefers to “hide” in the genes. The immune system of some people can track down cells in the genome of the pathogen over time. The new study involved 64 people (“elite controllers”), who are just part of this extremely small group of people who are able to live with HIV without taking antiretroviral drugs and, in fact, without needing the help of doctors: in their bodies, judging by all, the virus is isolated in such a way that it cannot reproduce.
Probably, the researchers suggest, the whole point is in powerful T-lymphocytes, which ensure the recognition and destruction of cells carrying foreign antigens. Apparently, these T-lymphocytes destroyed the cells in which HIV was “hiding” in more accessible parts of the genome. And the remaining infected cells kept the pathogen in those “distant” regions of the genome, where it could no longer create copies (this applied to 11 study participants). At the same time, about 10 percent of people taking antiretroviral drugs, especially those who started therapy immediately after infection, also successfully suppress HIV even after the end of the drug intake.
Among the test group was Loreen Willenburg, 66, from California, who was diagnosed with HIV in 1992. She has been involved in research for more than 15 years, and, with the exception of one test conducted several years ago (which showed a small amount of the virus), scientists have not been able to identify HIV in her tissues. Thus, for decades, her body was able to suppress the virus in a unique way. The patient appears to have achieved a “functional cure.”
The authors of the work explain their conclusions by the fact that they analyzed one and a half billion Willenburg blood cells, including using sophisticated new methods, and did not find any traces of the virus. The millions of intestinal and rectal cells studied also showed no signs of HIV.
“This unique group of people has provided a kind of proof of concept that the host’s immune response can achieve what is actually a clinical drug,” said Dr. Steve Dix of the University of California, San Francisco, one of the authors of the work. Scientists say this gives hope that the immunity of a small number of infected people who have followed antiretroviral therapy for many years can similarly detect the virus, “block” it, making it impossible to reproduce, and stop taking drugs. It is likely that such patients also need to be prescribed therapy to help strengthen the immune system.
Willenburg’s case is extremely important, because in the entire history of the circulation of the human immunodeficiency virus in the world, only three patients have been cured: for example, Adam Castillejo and Timothy Ray Brown got rid of the pathogen using stem cell transplantation, and a 35-year-old resident of the Brazilian city of São Paulo was treated according to the new scheme and was able to do without the grueling operation (however, some experts said that additional tests would be needed to confirm this discovery).
Of course, Willenburg’s cure has yet to be confirmed. “This is certainly encouraging, but it is still speculation,” recalled Dr. Una O’Dougherty, a virologist at the University of Pennsylvania. However, the physician noted that the results of the study and the analyzes of the patient as a whole impressed her.
The problem is that antiretroviral drugs can have serious side effects, including the risk of heart disease and organ damage, especially when medication is used for many years. Therefore, the so-called functional cure, if confirmed in the future, will change the lives of many HIV-positive patients.