HIV Patient Cleared Infection Without Antiretroviral Therapy

A woman from Argentina has become only the second person known to ever show no detectable traces of HIV infection without receiving a stem cell transplantation treatment to cure it. 

The patient was diagnosed with HIV in 2013, but after 8 years of follow up checks and a total of 10 commercial viral load tests, there appears to be no sign of active viral infection in her body, nor any evidence of HIV-1 associated disease. 

A sterilizing cure of HIV-1 infection has been reported in 2 persons living with HIV-1 who underwent allogeneic hematopoietic stem cell transplantations from donors who were homozygous for the CCR5Δ32 gene. 

The study results were published in the journal Annals of Internal Medicine. Despite the analysis of massive numbers of cells from blood and tissues, genome-intact and replication-competent HIV-1 were not detected in the patient, suggesting that she may have naturally achieved a sterilizing cure of HIV-1 infection, which raise the possibility that a sterilizing cure may be an extremely rare, but possible outcome of HIV-1 infection. 

During the patient’s eight years of follow-up after her initial March 2013 diagnosis, she only took antiretroviral drugs (ART) for one point (when she was pregnant in between 2019–2020). After delivering her healthy (and HIV-1-negative) baby, she stopped ART, and a comprehensive round of tests showed no signs of active virus.

“What distinguishes her from all other described elite controllers and post-treatment controllers is the absence of detectable intact HIV-1 proviruses and replication-competent HIV-1 viral particles in large numbers of cells,” the researchers write.

A similar case has been identified before, in a Californian patient called Loreen Willenberg, who has shown decades of drug-free remission, and no signs of intact virus in peripheral blood mononuclear cells (PBMCs) analysis.

“Does this imply that our patient has developed a sterilizing cure during natural infection? We believe this is likely, but it cannot be proved,” the researchers explain.

Despite not being able to call this seemingly natural phenomenon a ‘proof’, though, our inability to detect any sign of ongoing intact viral infection – despite comprehensive searching – is a huge win, and it’s something that could help us to reframe the boundaries of HIV research.

“This is a significant leap forward in the world of HIV cure research. Upon diagnosis, her tests surprised us all. Her HIV antibody test showed she was HIV positive, but the level of virus was undetectable and continued so, over time. This is highly unusual.”

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Sources: 

Peter Dockrill (2021, Nov 15). In Extremely Rare Case, a Woman With HIV Has “Cleared” The Virus Without Treatment. Sciencealert. Retrieved from:
https://www.sciencealert.com/extremely-rare-case-suggests-woman-was-naturally-cured-of-the-hiv-virus 

https://www.acpjournals.org/doi/pdf/10.7326/L21-0297

Image from: 

https://www.geneproof.com/geneproof-hiv-type-1-hiv-1-pcr-kit/p1129