AIDS patients show no signs of virus after drugs

Ah A Brazilian man infected with the AIDS virus hasn’t shown signs of it for more than a year since he stopped taking HIV drugs after a powerful drug therapy aimed at expelling the hidden dormant virus from his body. The doctor reported on Tuesday.

Scientists warned that the case needed independent validation and it was too early to speculate on a possible treatment.

“These are exciting findings, but they are very preliminary,” said Dr. Monica Gandhi, AIDS specialist at the University of California, San Francisco. “This happened to one, and only one,” and she said it was unsuccessful with the other four who received the same treatment.

“This is not a cure,” said another UCSF expert, Dr. Stephen Dicks.

The case was explained at the AIDS conference, and researchers also presented important preventive advances. A shot of the drug every two months was more effective than a daily Truvada pill, as it kept uninfected gay men from catching HIV from infected sex partners. Hundreds of thousands of people are now taking these “pre-exposure prophylaxis” medications, and this injection could offer new options, much like a temporary vaccine.

This is the first time HIV has been eliminated in an adult who has not received a bone marrow or stem cell transplant when a Brazilian male case was confirmed. An independent expert wants to see if his remission lasts, and about the intense drug combinations he received to take more tests.

“I’m so moved because millions of people want it,” said a 35-year-old man who told The Associated Press on the condition that his name wouldn’t be published. “It’s a gift of life and a second chance to live.”

Transplantation is a method that two other men called patients in Berlin and London have previously healed because of the location of treatment.

“I’m a living proof that I can be cured,” London patient Adam Castillejo said at a press conference at an online AIDS conference for the coronavirus pandemic.

He and a patient in Berlin, Timothy Ray Brown, had a donor with a gene that confers innate immunity to HIV infection. Doctors have tried other approaches because such transplants are medically dangerous and impractical to attempt on a large scale.

HIV is difficult to eliminate because it establishes an initial “reservoir” of blood cells that is dormant and is not attacked by drugs or the immune system. Infections can be controlled with drugs, but as soon as the patient stops taking them, the dormant virus activates and renews the disease.

Dr. Ricardo Diaz of the University of Sao Paulo, Brazil, led a study testing a powerful new drug combination that attempted to clean up this reservoir.

“I’m trying to wake up the virus,” Dias said, adding that the immune system is improving its ability to eliminate the virus after hiding it and clearing it. The Brazilian was taking a standard three-drug combo to suppress his virus. In September 2015, Diaz added two new drugs, dolutegravir and maraviroc, and nicotinamide, a type of vitamin B3 that helps expose dormant viruses, to enhance treatment.

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Almost a year later, the patient returned to the standard three drugs for a further two years and discontinued all HIV drugs in March 2019. Since then, the virus has gone undetected in many blood and tissue samples.

“We can’t search the whole body, but the best evidence is that no cells are infected,” Diaz said.

Most Compelling Evidence: Tests show that men have lost almost all HIV antibodies, a substance made by the immune system when fighting the virus.

The patient, who was eager for independent validation, said he went to a counseling center for an anonymous HIV test in February. It was negative.

“He made photos of the results,” and sent those photos, Diaz said.

The antibody results are “the most appealing part of the story,” Diks said. “These are solid scientists” and “the team may have come up with something to help,” he said, but he’ll do more testing to validate and see these results, he said. ..

In particular, doctors will want to see the evidence of blood tests that the patient really stopped his HIV medication. Mr Diaz said all HIV patients in Brazil were getting medicines from the government’s healthcare program, confirming that the men had stopped.

“I think it’s very promising. Diaz said the patient may heal, but it will take more time to find out.

Treatment was not successful with any of the other four treated in the same way, or with any of the other approaches related to the 30-person trial test.

Mr Diaz said he has received approval from a Brazilian government grant and a new study of 60 patients sponsored by ViiV Healthcare, a British company that manufactures maraviroc.

Dr Anton Pozniak, head of the AIDS conference and HIV specialist at Chelsea and Westminster Hospitals in London, said more time would be needed to see if the virus could come back.

“I’m waiting. I’m skeptical about all this… until a few years later,” he said.

About 4,600 people from the Americas, Asia and Africa participated in the individual prevention research. It tested shots of Viv’s drug, cabotegravir, against daily tablets of Turbada, a Gilead scientific drug already approved to prevent HIV infection.

The study was discontinued in early May, when injections appeared to be at least as effective as tablets. The final results show that shots work better, says research leader Dr. Rafael Landwitz of the University of California, Los Angeles.

“People can remain protected without taking drugs every day,” he said. “You’ve been hit and you don’t have to do anything for two months. It’s incredibly powerful.”

According to Gandhi, the results “may revolutionize HIV prevention around the world,” giving new options to those who don’t want to take medicine every day.

ViiV said it would seek approval for Cabotegravir in the United States. The final price is unknown. Truvada costs $1,600 to $1,800 a month, but the amount a patient pays from his pocket depends on insurance and other factors. With both drugs, the use of condoms to prevent other sexually transmitted infections is still required.

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