treatment may have cured Brazilian man of HIV

Experimental treatment may have cured Brazilian man of HIV


During this time of the COVID pandemic, many other significant medical issues have been pushed from our thoughts. One of these is HIV-AIDS. Recently, a research study from UFSP, presented at the (virtual) AIDS 2020 conference, has described a man who may have been cured with a new treatment regimen. 

HIV-AIDS has been described for nearly 40 years now, and we still have no cure. While we have good treatments to keep the disease controlled, only 2 patients—the “Berlin patient” and the “London patient”— have been proven to be cured so far.  Both had cancers (leukemia and lymphoma) that required bone marrow transplants to cure their cancers, and their doctors were able to give them new immune systems free of the HIV virus.

But bone marrow transplants are difficult and risky procedures, and not a practical way to cure HIV. Many researchers think that another approach will be needed for a cure, involving uncovering the HIV virus that hides in certain organs of the body, resistant to current medications. The hope is that if these viruses are released into the patients’ system, that they could be attacked with anti-retroviral drugs, and cure the patient of HIV. 

The Sao Paulo HIV study

The study from UFSP was based on this approach. The man who may have been cured (only identified as the “São Paulo patient”) first was diagnosed as HIV positive in 2012. Two months after he tested positive, he went on a standard 3 drug “cocktail” of anti-retroviral medications, and his “viral load” became undetectable. Patients like this are common now—they feel fine and their blood tests are good—but if they stop their drug cocktail, the virus quickly comes out of hiding and into their blood streams again. 

To prevent that, the UFSP researchers recruited this patient (and 4 others in the study) to take an additional 3 drugs during a 48-week period to see if they could flush out the virus from hiding, and completely clear out the virus. So from 2016 until 2017, the São Paulo patient took his regular cocktail along with 3 other medications, dolutegravir, maraviroc, and nicotinamide, which is a derivative of vitamin B3. 

After stopping the medications

After the 48 weeks of the additional 3 drugs, the 5 patients went back to their usual drug cocktail treatment. Then, in March 2019, they all stopped their medications completely to see what would happen. Unfortunately, four of the patients fairly quickly had return of the virus detected, but the one man did not. He has had blood tests every 3 weeks now for 66 weeks, and has no virus or viral antibodies detectable (meaning, his routine HIV blood antibody test is negative). 

Is this a lasting effect?

The UFSP researchers, as well as international experts, say it is too early to call this patient cured. They plan to carry out additional biopsies to see if virus could still be hidden in his organs and lymph nodes, but apparently due to the COVID crisis, these tests have been put on hold. 

Many experts at the AIDS meeting were skeptical that this “cure” will persist, and it is notable that the other 4 people in the study clearly were not cured. But it is possible that this one man had genes and an immune system that allowed him to be cured, and all that will be studied. We will keep you informed here how this case proceeds, and we hope a year from now he will still be virus-free.

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Esta postagem também está disponível em: Portuguese (Brazil)

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