Scientists believe a man in Brazil may have been potentially “cured” of HIV through the use of medication alone. The patient was placed on a new cocktail of antiretroviral drugs, along with nicotinamide, a form of vitamin B3.
Before the study, the 35-year-old already had an undetectable viral load due to a regular regimen of HIV medications. However, researchers conducted a trial to see if a new combination of drugs could drive down HIV infection even further.
After almost a year of treatment, scientists were unable to find any trace of the virus in his body, even when they looked for traces of viral DNA in sites where HIV is known to hide away (such as deep in the lymph nodes). He also showed a decrease in HIV antibodies, suggesting a lack of HIV present to prompt new antibodies.
He was then taken off all his medication. After 15 months, he has continued to show no evidence of HIV viral load. This has led scientists to optimistically hope HIV has been eliminated from his body.
Until now, only two other people are believed to have been “cured” of HIV. However, they both underwent high-risk bone marrow transplants as part of cancer treatment. It’s not a procedure that can be carried out on a mass scale.
The exciting result was presented yesterday at the AIDS 2020 virtual conference. The patient was diagnosed with HIV in 2012.
The researchers have speculated on how the new cocktail of drugs may have led to the result, including whether nicotinamide can stop HIV hiding in hard-to-reach parts of the body.
However, as exciting and interesting a development as this is, there are several reasons to keep optimism in check.
Firstly, four other people were given the same drug regimen in the small-scale trial and did not show the same evidence of HIV remission.
Secondly, it’s not unprecedented for someone with an undetectable viral load to stop taking medication and still be undetectable up to a couple of years later (although it is rare and doctors would advise anyone to always stick to their drug regimen). It remains to be seen whether the so-called “Sao Paolo Patient” will again show evidence of HIV in the future.
Dr. Ricardo Diaz of the University of Sao Paulo in Brazil, who co-led the study, told The Telegraph: “We can’t search the entire body, but by the best evidence, we do not have infected cells.
“I think it’s very promising. This patient might be cured.”
Italian researcher, Andrea Savarino, who was also involved with the study, told aidsmap, “’This case is extremely interesting, and I really hope that it may boost further research into an HIV cure.”
As attempts to create an HIV vaccine have repeatedly faltered, any new advances that lead to long-term HIV remission are to be welcomed. It’s already known that those with an undetectable viral load cannot pass the virus on to others and can expect to live a normal lifespan. If this could be achieved without having to take life-long medication, all the better.
However, Dr. Steven Deeks of the University of California in San Francisco, urged caution, telling aidsmap: “The fact that it’s a single case suggests that this may not be real. We know that some people can achieve what appears to be remission with antiretroviral drugs alone. This may simply be a person who got lucky with antiretrovirals.
“I would not encourage anyone to run out to the local health food store and get this drug, and don’t stop taking antiretrovirals.”