A female patient was diagnosed with human immunodeficiency virus (HIV) in 2006, and she managed to control the infection without any treatment for 15 years, according to the Spanish newspaper Herald. She is the first patient in the world to successfully control the infection for such a long period of time without any medication and is considered functionally cured of AIDS.
Researchers and doctors from the Barcelona Hospital and a biological institute in Catalonia have been working with the patient for many years, and in the process have discovered how her immune system works effectively against the infection, leading to the development of an effective cure for AIDS Rekindle hope.
For now, many HIV-infected people continue to receive antiretroviral drugs after diagnosis to reduce the concentration of the virus in the body and prevent the virus from replicating further. However, some viruses are still dormant, hiding in cells and forming virus reservoirs. If treatment is interrupted, the virus in these reservoirs is reactivated and the infection becomes active again. For this reason, the vast majority of diagnosed patients receive lifelong antiretroviral therapy.
However, there are also some very rare cases: some patients have protective genetic factors, and in the absence of any treatment, the immune system will produce a very strong CD8+ T cell effect, thereby suppressing the virus; Deficiency of the virus that has received a bone marrow transplant or has been infected. In addition, there is a small group of patients, known as HIV “post-treatment controllers,” who have been on antiretroviral drugs for a period of time and are able to control their viral infections for months or even years if they stop taking them.
However, this patient from Barcelona is different from these cases. Sixteen years ago, she was diagnosed in the acute phase of an infection that required hospitalization and was enrolled in a clinical trial. For 9 months, in addition to antiretroviral therapy, she also took an immunosuppressive drug, cyclosporin A, for the first 8 weeks. After stopping the medication, the patient continued to control the infection for 15 years, although she did not have the protective genetics that elite controllers did.
Nuria Clement, a researcher involved in the study, said: “The patient was treated with antiretroviral drugs and immunomodulatory therapy, and after stopping the treatment, she was able to control the virus on her own. This situation is shocking because She has maintained it for more than 15 years.” She added: “We also found a gradual decline in its viral reservoir over time, suggesting that the immune system is playing an important role.”
The research team was just held in Montreal, Canada. The case was presented at the 2022 International AIDS Conference. The researchers decided to conduct a systematic study of the mechanisms that gave the Barcelona patient this ability. They first experimented with the patient’s CD4+ T cells, the main target of HIV, exposed them to a virus-laden environment and found that the cells were infected. However, when the researchers put the virus into a sample with blood cells, infection with the virus was suppressed, giving them a clue.
”We found a signature of these cells, which are specialized cells of innate immunity — natural killer cells and CD8+ T cells. It was these two cell subtypes that controlled the virus infection in this patient,” Clement said. This is a new self-healing mechanism that we have discovered.”
The team leader, Josep Malloras, emphasizes: “This study opens up a new avenue to develop these cellular activities that mimic the innate response of this patient. Or therapies that enhance its activity so that more people can benefit from this functional cure without treatment.”
Although the patient in Barcelona still had the virus, the viral load was undetectable, so she could no longer The virus spreads to other people. Researcher Juan Ambroscioni noted: “It is worth mentioning that she is a female patient, because in HIV studies, most of the volunteers were men who had sex with men, but it was women who had HIV. The group with the highest infection rate.” He also said that the patient’s condition was notable because “she has reached a certain age”, which is important because “the control effect of all infection processes will follow decrease with age.”