A Brazilian man may be in long-term remission from HIV after an experimental regimen of medication, researchers say.
The 36-year-old, who was not identified, has not shown any signs of HIV for more than a year after stopping his daily medication. That’s according to scientists at the University of Sao Paulo in Brazil, who also note the man doesn’t have detectable antibodies to the virus either.
The patient received his HIV diagnosis in 2012, and started taking standard antiretroviral therapy (ART) drugs.
In 2016, he and four others joined a medical trial in which they received standard ARTs as well as three other existing drugs for 48 weeks.
The patient returned to standard treatment after the trial. Then in March 2019, he stopped all medication under the researcher’s supervision.
Normally, the virus would rebound to high levels within weeks. However, doctors have tested the Brazilian man’s blood every three weeks and found no signs of the infection, lead researcher Dr Ricardo Diaz explained.
“We can’t search the entire body. But by the best evidence, we do not have infected cells,” Diaz said.
However, the virus did rebound in the other four patients in the trial who took the same intensive drug regimen.
A “cure” for HIV is so challenging because the virus hides from the immune system in so-called reservoirs in the body. As a result, any strategy to rid the body of HIV must flush it out.
Dr Diaz said the researchers used the new drug combinations to try and “wake up” the dormant HIV, luring it out of hiding where other drugs can eliminate it.
Independent experts caution the “preliminary” results need verification as well as further testing and study.
They want to see if the Brazilian man’s remission continues, or whether his HIV does eventually rebound.
HIV patients’ results are interesting, but larger scale studies needed
Dr Ricardo Diaz presented findings from the patient’s case study at the International AIDS Conference 2020, held online this week.
Professor Sharon Lewin, an HIV expert at the University of Melbourne not involved in the case, told the UK’s Telegraph the patient’s lack of antibodies was significant.
“When someone is infected with a virus they make antibodies. And antibodies don’t budge, even when you’re on treatment and there’s no detectable viral load,” she said.
“But this showed he had no antibodies which is supportive of him being cured.”
However Professor Lewin cautioned that while the case is interesting, its significance is hard to know with just a single patient.
“I would be super excited to see long term remission in multiple participants in a clinical trial. This is what the field needs to really advance.”
People living with HIV take daily medication to suppress the virus to undetectable levels. This allows them a long, healthy life and prevents HIV transmission to sex partners.
In recent years, doctors have described two other men in long-term remission as “functionally cured” of HIV.
However both men, from Berlin and London, underwent extremely risky and complex bone marrow transplants as part of cancer treatment.
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