They identify the second person in the world to be cured of HIV without having received medical treatment

Dr. Xu Yu, a member of the Ragon Institute, of the Hospital General de Massachusetts, in the United States, and his team have identified a second untreated person with HIV who seemed to have overcome the virus, as published in the journal ‘Annals of Internal Medicine’.

The patient showed no evidence of intact HIV genomes in more than 1.5 billion cells blood and tissue tests, suggesting that the virus had been eliminated from the patient’s body.

Xu Yu studies how HIV stores copies of its genome in human cells, leading to lifelong infection, and in 2020 he identified a first untreated HIV patient who appeared to have cleared the virus.

During the infection, HIV places copies of its genome in the DNA of cells, creating what is known as a viral reservoir. In this state, the virus effectively hides itself from anti-HIV drugs and the body’s immune response. In most people, new viral particles are constantly being produced from this reservoir.

Killer T cell, key

Antiretroviral therapy (ART) can prevent new viruses from being produced, but cannot remove the reservoir, so a daily treatment is necessary to suppress the virus.

Some people, known as elite controllers, have immune systems capable of suppressing HIV without the need for medication. Although they still have viral reservoirs that can produce more HIV virus, a type of immune cell called Killer T cell keeps virus suppressed without the need for medication.

Dr. Xu Yu, a member of the Ragon Institute at MGH, MIT, and Harvard, has studied the HIV reservoirs of elite controllers. His research group identified a patient who did not have any intact HIV viral sequences in her genome, indicating that your immune system may have cleared the reservoir of HIV, what scientists call a sterilizing cure.

Yu’s team sequenced billions of cells from this patient, known as the San Francisco Patient, looking for any HIV sequences that could be used to create a new virus, and found none. This extraordinary finding, the first known incidence of a sterilizing cure without a stem cell transplant, was published in ‘Nature’ in 2020.

Yu’s group is now reporting a second untreated HIV-infected patient, known as the Patient of Hope, which, like the San Francisco Patient, does not have intact HIV genomes found in more than 1.19 billion blood cells and 500 million sequenced tissue cells.

“These findings, especially with the identification of a second case, indicate that there may be a course of action for a sterilizing cure for people who are not able to do it themselves, “says Yu, who is also a research physician at Massachusetts General Hospital.

He further explains that these findings may suggest a specific killer T-cell response common to both patients that drives this response, with the possibility that other people with HIV have also achieved a sterilizing cure. If researchers can understand the immune mechanisms underlying this response, could develop treatments that teach other people’s immune systems to mimic these responses in cases of HIV infection.

Yu explains that they are now studying the possibility of inducing this type of immunity in people on antiretroviral therapy through vaccination, with the aim of educating their immune systems to be able to control the virus without antiretroviral therapy.