HIV/Aids antidote hopes recede

HIV/Aids antidote hopes recede as first ‘cured’ patients relapse

A major discovery in HIV is good news for South Africa, where about 1 in 10 are HIV-positive. Patients previously believed ‘cured’ of HIV have experienced a viral rebound, marking an important new question: if HIV can remain in the body while undetectable in the blood, where might the ‘deep reservoir’ that harbours the virus be?

HIV/Aids antidote hopes recede


The reappearance of HIV in patients who had previously been believed ‘cured’, meaning that the Human Immunodeficiency Virus had been ostensibly eliminated from their bodies, has been hailed by scientists working in the field as ‘disappointing but scientfically significant’. The result, while it is surely a blow to the patients who had been living as one of a handful of ex-HIV-positive people in the world, is also an important milestone in the understanding of HIV, the virus that causes Aids (Acquired Immune Deficiency Syndrome).

The news was announced by a team at Brigham and Women’s Hospital in Boston, one of the USA’s leading hospitals. By early 2013, researchers were no longer able to detect HIV in the blood of two male patients who had undergone bone-marrow transplants for lymphoma, a cancer of the blood. By March, both patients stopped taking anti-retroviral (medicines that inhibit the development of the Aids virus). However, by August and November of 2013, first one and then the other patient had relapsed.

The key finding prompted by the relapse is that HIV is able to persist inside the human body when even the most sensitive blood tests fail to pick it up. Its recurrence in people previously believed cured meant that the virus rebounded to measurable quantities in the blood in patients who had tested clean for the virus for over 8 months after the transplant. 

Timothy Henrich, a researcher at the hospital, said that “through this research we have discovered [that] the HIV reservoir is deeper and more persistent than previously known and that our current standards of probing for HIV may not be sufficient to inform us if long-term HIV remission is possible if antiretroviral therapy is stopped. We have also learned that there may be an important long-lived HIV reservoir outside the blood compartment. Both patients have resumed therapy and are currently doing well. I am thankful for their commitment to research and our shared dedication in understanding this virus to benefit all HIV patients.”

Bone marrow transplants have previously appeared to eliminate the HIV virus from a small number of patients, but the procedure is so risky and costly, and donors so rare, that it is not considered a viable therapy for combatting HIV in the general population. The only person known to have had his or her HIV status reversed to date is Timothy Brown, the ‘Berlin patient’, who received a stem-cell transplant from a donor with a rare mutation that inhibits HIV’s ability to infect the body. In light of the recent findings, doctors advocate speaking of ‘remission’ rather than a ‘functional cure’ for people whose HIV status appears to have been reversed. 

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