After forty years, HIV remains prevalent across the globe. With current estimates from the WHO showing that there are 36.3M people currently living with the disease and another 1.5M new infections per year, there is much work to be done. But despite these numbers, there is hope that scientists and medical researchers will find a vaccine or even a cure. 2021, while in many ways a challenging year due to COVID, has seen a few advancements in HIV research that has given us hope that one day, the world will see a cure and a vaccine for HIV.
In HIV News Today
A few weeks ago, we wrote about the first-ever human trials for HIV using the gene-editing technology CRISPR and the promise this holds toward eventually discovering an effective, reliable, and safe cure. This week in HIV cure news, a woman from Argentina appears to have rid herself of HIV without drugs or treatment, which is only the second documented case of this – worldwide! After testing more than a billion cells, doctors found no viable traces of the infection in her body, which is astounding and offers hope to the over 36 million people living with HIV right now! The medical community refers to her as the ‘Esperanza patient,’ after the town in Argentina where she lives. In English, Esperanza means hope which is fitting given the amazing news that she was able to rid herself of HIV without treatment!
This news is in addition to a study released last year that mentioned another cohort of elite controllers, specifically a patient from San Francisco who also appears to have been functionally cured of HIV without treatment.
Does This Mean You Can Get Rid Of HIV If Infected?
Well, for 99% of people, not yet. But this does hold promise for researchers in their ongoing work towards a cure. While there have been cases of patients who have successfully rid the virus using treatment options such as stem-cell therapy, this is still incredibly rare. One person, Adam Castillejo from London, United Kingdom, has been free of HIV since his treatment for cancer that also rid the virus from his body. Fortunately for Adam, the stem cell treatment donor was one of the 1% of people born with genes that prevent HIV from entering and infecting cells.
However, it is important to remember that these treatments are not without risk and are often quite aggressive, mainly used to fight patients’ cancers rather than HIV, so at this time, it is not widely offered to patients. Nonetheless, patients such as Adam offer the community hope that they will see a cure in this lifetime.
Are There People Naturally Immune To HIV?
While the evidence is starting to show that there are people that do seem to have natural immunity, more research is needed to understand more about why some people, estimated at 1 in 200 from a recent research paper, are able to rid their bodies of HIV without the use of sterilizing treatments.
There are other individuals, such as the Esperanza patient, called “elite controllers,” that can naturally achieve what most require the use of a “sterilizing cure” to do. Eight years after diagnosis, the Esperanza patient, who has received no treatments, continues to show no signs of active infection or signs of intact virus within her body.
This research paper, released November 2021, shows tremendous promise for an HIV cure; however, at this time, most people who get HIV still need life-long ART (antiretroviral therapy) that, without, will see the virus reawaken, which lays dormant while treatment continues.
And while researchers say that they cannot be 100% sure at this time without new technology to confirm that there is absolutely no intact or functional virus, this news brings hope that with advancing technology, scientists will unlock the key to elite controllers and those with natural immunity, harnessing these capabilities to develop a cure.
How Does HIV Infect the Immune System?
HIV is a difficult disease to both treat and cure due to the nature of the virus itself. HIV is a unique human RNA virus capable of infecting cells in the body’s immune system. HIV targets T helper cells (also called CD4 cells), leading to the eventual death of the cell. These CD4 cells are essential in the regulation of immune responses. HIV replicates quickly. In an infected person not on treatment, approximately 10 to 100 billion new viruses are produced daily, leading to a substantial loss of CD4 cells over the years. This destruction of CD4 cells renders a patient vulnerable to infections that are usually rare in people. People that succumb to AIDS generally die from an infection (called opportunistic infections) that the body cannot fight off.
So, What’s Next For Researchers?
The next step for researchers looking to answer the decades-long question, “is there a cure for HIV” is to analyze and determine the mechanisms on how the Esperenza patient and those such as the San Franciscan patient works to “naturally” eradicate HIV from their systems. This next phase researchers will take is key to understanding why these patients and those considered elite controllers can either contract HIV and naturally rid their bodies of it or show a natural resistance to even contracting it.
Another study released in 2020 found that individuals’ immune systems appear to have the ability to preferentially destroy cells that have HIV capable of producing viable new copies of the virus. One theory from the study authors is that these two women mounted a potent killer T-cell response to the virus. This is one direction for researchers to explore.
Does this mean there is a cure for HIV?
So while we are not quite there yet in terms of finding a cure that works for a broad swath of people, the findings of a second woman who appears to have rid herself of HIV offers hope and a way to further vaccine and cure research, bringing us one step closer to ending HIV as a public health crisis.
HIV is a tricky virus that our immune systems struggle to fight off, especially long-term. Nature Immunology and Nature Medicine created an excellent video that explains how our bodies react to HIV and try to fight it off.
References
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