A second HIV patient may’ve been ‘cured’ of infection without drug use

BOSTON: The world’s second HIV patient whose body appears to have rid itself off the virus without the use of antiretroviral drugs has been identified, scientists said on Tuesday.
The finding, published in the journal Annals of Internal Medicine, shows that the untreated person, known as the Esperanza Patient, living with HIV had no evidence of intact viral genomes in more than 1.5 billion blood and tissue cells analysed. The international team noted that if the immune mechanisms underlying this response can be understood by researchers, they may be able to develop treatments that teach others’ immune systems to mimic these responses in cases of HIV infection.
During infection, HIV places copies of its genome into the DNA or genetic material of cells, creating what is known as a viral reservoir, the researchers said. In this state, the virus effectively hides from anti-HIV drugs and the body’s immune response, they said. In most people, new viral particles are constantly made from this reservoir. Anti-retroviral therapy (ART) can prevent the new viruses from being made but cannot eliminate the reservoir, necessitating daily treatment to suppress the virus.
The researchers noted that some people, known as elite controllers, have immune systems that are able to suppress HIV without the need for medication. Though they still have viral reservoirs that can produce more HIV virus, a type of immune cell called a killer T cell keeps the virus suppressed without the need for medication, they said. In their previous study, the scientists identified one patient who had no intact HIV viral sequence in her genome, indicating that her immune system may have eliminated the HIV reservoir — what scientists call a sterilising cure. The finding, the first known incidence of a sterilising cure without a stem cell transplant, was reported in Nature in 2020.