For the first time, an HIV-positive patient has gone into long-term remission after being treated with a multi-drug cocktail raising hopes of a possible cure on the horizon.
The patient, a 34-year-old Brazilian man diagnosed in 2012, was put on a three-drug regimen of antiretroviral therapy (ART) which was intensified with additional antiretrovirals plus a skin cancer preventative called Nicotinamide, a water-soluble version of vitamin B3.
Dr. Andrea Savarino, of the Instituto Superiore di Sanitá in Rome, Italy, explained the approach in a presentation to the UK organization AIDSmap prior to the 2020 International AIDS conference in San Francisco.
The intensified treatment was stopped after 48 weeks and he returned to his normal three-drug regimen.
In March 2019, he began a medically-supervised treatment interruption, stopping his antiretroviral therapy. His last tests (taken on June 22, 2020) show his viral load has remained undetectable, meaning he has maintained viral suppression for more than 65 weeks without antiretroviral medications. The patient’s HIV antibody tests also came back negative.
“The virus did not rebound, the viral DNA was maintained negative,” Savarino said. “The antibody response decreased over time, if the antibody decreases, it is possible that the virus has stopped its repetition.”
While exciting news, Savarino cautions “the result is highly likely not to be reproducible,” describing these results as “preliminary.” He noted that four other patients were given the same regimen but HIV was not found to have been put in check in those individuals.
The Brazilian patient is still being monitored to see if HIV has truly been eradicated from his system.
Since the early 1980s, scientists have worked diligently to find a cure for HIV, which has infected more than 75 million people and killed almost 33 million since the AIDS epidemic began.
Modern medications available today allow patients to control the virus and keep HIV in check, but Reuters reports there are an estimated 38 million people are currently living with HIV.
There have been three prior reports of individuals apparently being ‘functionally cured’ (long-term remission) of HIV, but those cases were the result of complicated, invasive bone marrow transplants.
All three received transplants from donors with a mutated gene for the CCR5 protein found on white blood cells. While HIV relies on the protein to enter the cells, the mutated version apparently blocks the virus from attaching to those cells.