Did 14 more patients become “cured” of HIV? #HIV #AIDS
I’m going to put the “cure” in quotations because this is all coming fast and furious on the information highway, which is why I sat on this story until today. (I’ve been lurking in a discussion on an HIV News board around this topic) I can’t functionally call this a cure because.
- People are far too quick to pronounce studies like this as a cure when it’s so far from the finish line in terms of actual clinic trials and wide spread disbursement.
- The scientists who ran the trial don’t have a definitive answer on why these people can stay off meds. There is no “Eureka!” moment here. Just a lot of enthusiasm and the potential answers.
- A REAL cure would cure everybody, not just be an answer for the newly infected. Those who have had it for 30 years and those that get diagnosed today could step up to the front for their medical solution to being HIV positive.
There are two articles on this. First, the highly technical one:
The 14 patients with durable viral control were found at a number of French clinics and became the subjects of a study called VISCONTI (Virological and Immunological Studies in CONtrollers after Treatment Interruption).
There were ten men and four women who had been infected with HIV between 1996 and 2002. All had started ART within ten weeks of primary HIV infection being detected and in all but two cases PHI was symptomatic. Viral load when first measured was high (average, 100,000 copies/ml), in contrast to spontaneous HIV controllers, who maintain low viral loads from the start. Four started ART within four weeks of infection, the others within ten weeks.
They took ART for at least one year and for an average of three years, with the earliest-diagnosed taking regimens that would now be considered suboptimal, such as dual or triple-NRTI therapies. They then stopped ART and have stayed off it for a minimum of four years and an average of 7.5 years (longest so far, 9.5 years).
During the time off treatment, eight people have not had a single viral load result above 50 copies/ml and only two had any viral load over 400 copies/ml. Four have had a pattern of periods of low but detectable viral load and in three of these, their last viral load was detectable (91, 224 and 289 copies/ml respectively).
Median CD4 count at ART initiation was 502 and at ART discontinuation was 927 cells/mm3; since then median CD4 count has declined slightly to 837 cells/mm3 but in five cases has actually increased.
And the more simplified version, for everyday Joe’s like me:
The four women and 10 men still have traces of HIV in their blood, but at such low levels that their body can keep it in check without drugs. The 14 adults have been off medication for an average of seven years. One person has gone 10.5 years without drugs.
“It’s not eradication, but they can clearly live without pills for a very long period of time,” Sáez-Cirión told NewScientist magazine. While Sáez-Cirión warned that rapid treatment does not work for all patients, the new study stressed that early intervention is absolutely necessary.
“There are three benefits to early treatment,” Sáez-Cirión said. “It limits the reservoir of HIV that can persist, limits the diversity of the virus and preserves the immune response to the virus that keeps it in check.”
Researchers are working to identify factors that could explain why early intervention functionally cures some people, and not others. “This whole idea is fascinating, and we’ve been looking very closely at issues of early initiation of treatment, and the potential for functional cures,” said Andrew Ball, senior adviser on HIV/AIDS strategy at the World Health Organization.
Further analysis showed that the 14 adults were not super-controllers – the 1 per cent of the population that is naturally resistant to HIV – because they lacked the necessary protective genes. Natural controllers also rapidly suppress their infections, whereas members of the Visconti cohort had severe symptoms which lead to their early treatment.
Take it all with a grain of salt. There’s far more questions in this study trial than available answers. Just the same, it is encouraging news that challenges the old belief that starting treatment is best kept until later after seroconversion.
(thumb via the RT linked article)