The second-known person to naturally cure their HIV infection has been discovered by scientists in Argentina, raising hopes for a future cure.
The Argentinian woman in her thirties, from the city of Esperanza, was found to have no disease-causing or ‘intact’ virus, eight years after being diagnosed.
A group of Harvard-based scientists announced the discovery yesterday at a major international meeting of HIV experts.
Known only as the ‘Esperanza patient’, she is the second person to be found to have no intact virus. The first — Loreen Willenberg, 67, from San Francisco — was found in August.
The discovery could bring a potential cure closer to the 38million people living with the AIDS-causing infection worldwide.
‘Finding one patient with this natural ability for functional cure [no virus that can reproduce] is good, but finding two means so much more,’ said Dr Natalia Laufer, the patient’s doctor and an HIV researcher in Buenos Aires, according to The Times.
‘It means there must be more people like this out there,’ she said. ‘This is a significant leap forward in the world of HIV cure research. Upon diagnosis, her tests surprised us all.’
The patient — whose ex-boyfriend died of AIDS — was diagnosed with HIV in 2013.
Her current boyfriend and newborn baby are both HIV negative, Dr Laufer said, who called her a ‘healthy, athletic and beautiful woman’.
The two women — the Esperanza Patient and Willenberg — are extreme examples of a rare group of people known as elite controllers, who have never taken antiretroviral therapy to fight the virus, and who show no signs of the virus in their blood.
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Normally, when a person gets HIV, the virus attaches to their immune cell’s DNA, reproducing from there.
Why is HIV so hard to cure?
In 1995, researchers discovered why HIV manages to come back even when it seems to have been defeated.
The virus buries part of itself in latent reservoirs of the body, lying dormant as ‘back-up’.
In 1996, it was discovered that anti-retroviral therapy (ART) could suppress the virus, and prevent it from resurging, if the medication was taken religiously.
But once that blanket is lifted, the virus swiftly rebuilds itself.
Despite decades of attempts, experts still don’t know how to get at those hidden parts of the virus.
The most promising approach may well be a ‘shock and kill’ technique – awakening the virus out of its hiding place then blitzing it.
But researchers don’t yet know how to wake it up without harming the patient.
A handful of HIV-infected patients who also had cancer have been left in long-term remission after undergoing a risky stem cell transplant.
The so-called ‘Berlin patient’ Timothy Ray Brown was the first to undergo the life-threatening procedure 13 years ago, which gave him a bone marrow transplant from a donor with HIV-resistant genes that wiped out his cancer and the virus in one fell swoop.
But for one in 200 people, the elite controllers, most of the virus settles into inactive parts of the genome, known as ‘gene deserts’, causing no harm. The remaining virus is cleared up by the body’s immune system.
The virus harms people’s ability to fight other infections, with the most severe and deadly stage known as AIDS.
Current anti-viral drugs ensure HIV-positive patients’ immune systems are healthy to reduce the risk of the disease advancing, but they’re costly.
Professor Xu Yu, an HIV researcher at the Ragon Institute, Harvard Medical School, said that previous cases where a patient had been ‘cured’ involved high-risk stem cell transplants for patients with terminal cancer.
The so-called ‘Berlin patient’ Timothy Ray Brown, a US man treated in Germany 13 years ago, survived the life-threatening procedure, which gave him a bone marrow transplant from a donor with HIV-resistant genes that wiped out his cancer and the virus in one fell swoop.
The finding of the Argentinian woman, Professor Yu said, and the understanding of how the bodies of elite patients deal with the virus ‘opens a door to a potential cure’, she said.
The work announced at the Conference on Retroviruses and Opportunistic Infections provides the most convincing evidence to date that scientists are making significant progress towards a cure for HIV.
Exactly where HIV genetic material is located in the body was shown by the scientists, who also said that mimicking the pattern in elite controllers may be key.
Hopes for a new treatment rose in recent months after a study of more than 10,000 people identified a rare group with controlled HIV in Africa.
Scientists found the group from the Democratic Republic of Congo – where the disease originated – tested positive for HIV antibodies but had low to non-detectable viral load counts without antiretroviral therapy.
These people are known as HIV elite controllers, researchers from the US National Institute of Allergy and Infectious Diseases say.
The discovery could lead researchers closer to their goal of ending the HIV/AIDS pandemic, which has killed about 39 million people globally.
‘Finding of a large group of HIV elite controllers in the DRC is significant considering that HIV is a life-long, chronic condition that typically progresses over time,’ Johns Hopkins Centre for Global Health director Tom Quinn said.
Dr Quinn said there had been previous cases where the virus did not progress in a small number of people but the high-frequency in the DRC suggested there was something happening at a physiological level that’s not random.
‘The global research community has more work to do but harnessing what we learn from this study and sharing it with other researchers puts us closer to new treatments that could possibly eliminate HIV,’ Abbott principal scientist and study author Mary Rodgers said. The study was published in The Lancet’s EBioMedicine.