Harvard scientists identify a second HIV patient whose body appears to have cleared the virus

They wanted to do the same for her placenta. Because the placenta is a fetal organ, it is packed with maternal immune cells, an environment rich in targets for mining stealth virus.

As a scientist report At the Annals of Internal Medicine on Monday, they found nothing. This means that a woman, who she calls an “Esperanza patient” to protect her privacy, appears to have eradicated the deadly virus from her body without the help of drugs or bone marrow transplants. I have cured HIV.

“This gives us hope that the human immune system is powerful enough to control HIV and eliminate all functional viruses,” said an immunological scholar at the Massachusetts Institute of Technology Ragon Institute. Yes, says Harvard University and senior author Dr. Xu Yu. About the new report. “As time goes on, I believe she has reached bactericidal treatment.”

Previously announced at a conference on retroviruses and opportunistic infections in March, researchers said the findings could help identify possible treatments.

Approximately 10 years after the AIDS pandemic, doctors began to find a small number of patients who tested positive for the HIV virus but were asymptomatic and then found to have very low levels of the virus in their bodies. At that time, these case studies were estimated to be one-off.

But the more doctors saw, the more they found such patients.The past few decades have revealed that people with unusually strong immune responses make up. About 0.5 percent Of the 38 million people living with HIV on the planet. Scientists call these people “elite controllers,” and in recent years they have been the subject of enthusiastic international research.

In a patient who was seen by Dr. Stephen Dikes, a longtime HIV researcher and professor of medicine at the University of California, San Francisco, the researchers did not find an intact virus in more than 1.5 billion of her cells. Loreen Willenberg, a 67-year-old California woman, maintained control of the virus for almost 30 years without the use of antiretroviral drugs. If the Esperanza patient is the second person known for the spontaneous cure of HIV, Willenberg is the first person.

Their bodies can represent a model of HIV treatment. Once researchers understand why elite controllers are special, they pack them into drugs, gene therapy, or other one-off treatments that can free millions of people from the lifetime of antiretroviral drugs. You may be able to.They may find a way to boost the immune system Non-responder — People who are very sensitive to many other health problems because their natural defenses have been so destroyed by HIV.

One of the dirtyest tricks of HIV is that when HIV enters a cell (usually a T cell or other immune cell), it makes its own DNA copy that integrates into the cell’s genome. Therefore, when the cell’s protein-producing mechanism encounters that bit of the viral code, it unknowingly makes more copies of the HIV invader. Antiretroviral drugs disrupt this process and spend time on the patient’s immune system to find and kill these hijacked cell factories. However, some DNA copies of the virus blueprint survive. In theory, they could wake up at any time and start making the virus.

That is why people need to take antiretroviral drugs for the rest of their lives and can never be cured. Physicians have no way of attacking or clearing these potential integrated HIV genomes. And until recently, there wasn’t even a good way to detect them. But Yu’s group is at the forefront of developing ways for scientists to break down billions of immune cells and look for smoking bodies from past infections to classify DNA.

Dikes said he wanted to know more about what happened in the first days and weeks after the Esperanza patient was infected. For some reason, her body did not develop antibodies against all of the various expected HIV proteins. This suggests that her natural defenses quickly hit the brakes on viral replication before the virus spread and overwhelmed the immune system. Usually it only happens if someone starts an antiretroviral drug very early.

It can be a little difficult to study what happened to someone’s body nearly 10 years ago. Many immune system players are transient molecules, and it may now be nearly impossible to find evidence of them, such as trying to find fossils of jellyfish and flatworms. But Dikes said that comparing gene expression in his DNA and immune cells to other patients might reveal something interesting.

These are the types of analysis that Yu’s group is currently working on with Dr. Natalia Laufer, an HIV researcher at El Institutode Investigaciones Biomédicasen Retrovirusy SIDA in Buenos Aires, who is studying elite controllers, and a doctor for Esperanza patients.

A patient with Esperanza told STAT in an email that he was not in a special mood but was blessed about how the virus behaves in the body. “I feel great responsibility and commitment to achieve this just by thinking that my condition may help achieve treatment for this virus,” she writes. Her first child was healthy and not infected with HIV, and she and her partner are now expecting a second child, said a woman who does not want to be named.

Raufer calls it a “beautiful coincidence,” and Esperanza translates it as “hope.”

“The ability of an individual to heal himself is a change in the HIV paradigm,” Laufer said. However, she added, they may not be “curing” for sure because of the impossible task of sequencing all the cells of the patient. However, Loafers said: “There are signs that some individuals may have complete control over HIV infection, and that’s very different from what we thought 40 years ago.”

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