New studies presented at the 24th International AIDS Conference present isolated cases of AIDS cure – Agência AIDS

This Sunday morning (31) two studies on isolated cases of recovery from AIDS were presented during the main session of AIDS 2002, which could shed new light on the subject. “The cure remains the holy grail of HIV research,” said Sharon Lewin, IAS president-elect and director of the Peter Doherty Institute for Infection and Immunity. “We’ve already seen a handful of individual remedies, and the two featured today offer continued hope to people living with HIV and inspiration to the scientific community.”

Stem cell transplant recipient becomes fourth known adult case of HIV cure

A 66-year-old Caucasian man who received a stem cell transplant is the fourth known person to go into remission from HIV. Data presented this Sunday by City of Hope’s Jana Dickter describes the case of a man, diagnosed with HIV in 1988, who received chemotherapy and an allogeneic hematopoietic stem cell transplant (aHCT) after developing acute myeloid leukemia in 2018. Previously, he had an undetectable HIV-1 viral load on ART for many years. The recipient continued ART for 25 months after aHCT and his ART levels remained undetectable 12 months after discontinuation of analytical treatment. From 14 months after stopping treatment and 39 months after transplantation, there is no evidence of HIV RNA rebound and no detectable HIV DNA. HIV-1-specific humoral decline and no detectable HIV-specific cellular immune response were observed. Human CD8-depleted peripheral blood mononuclear cells remained uninfected after ex vivo challenge with R5 strains of HIV. Immunological studies 37 months after aHCT and 12 months after discontinuation of analytical treatment showed a robust response to cytomegalovirus stimulation and no response to HIV CD4 and CD8 T cells. This case may open the opportunity for seniors living with HIV and blood cancer to receive a stem cell transplant and enter remission for both diseases

A Unique Case of Functional HIV Cure

This latest case of functional cure sheds new light on the mechanisms by which some people manage to control the virus after receiving antiretroviral therapy.

Hospital Clínic-IDIBAPS presented an exceptional case of functional cure of AIDS during the International AIDS Conference 2022. A patient, after stopping antiretroviral treatment, has absolute control of HIV replication, maintained for more than 15 years, with an undetectable viral load and not taking medicine to fight the virus.

Communication at the conference was led by Núria Climent, researcher in the IDIBAPS AIDS and HIV infection group, led by Josep Mallolas; Josep M. Miró, specialist in infectious diseases at the Hospital Clínic, head of the IDIBAPS group and president of medicine at the University of Barcelona; Juan Abrosioni, doctor in the HIV clinical hospital unit and researcher in the IDIBAPS AIDS and HIV infection group; and Sonsoles Sánchez-Palomino, a researcher from the same group. All are CIBER Infectious Diseases (CIBERINFEC) researchers.

The study describes the immunological mechanisms of a female post-treatment controller that confers complete control of HIV replication over more than 15 years. The patient was diagnosed in the acute phase of HIV infection and was included in a clinical trial with antiretroviral treatment for 9 months and different modulating interventions with cyclosporine A, an immunosuppressive agent. “The patient had no genetic factors associated with HIV control, was not an elite controller of the disease and, in addition, had severe infection in the acute phase, which is rare in post-controllers. treatment,” said Josep Miró.

In addition, it was demonstrated that the patient is not infected with defective viruses, that is to say that her virus was viable because it was possible to isolate and cultivate it in the laboratory. “During these years, we have seen a sharp and gradual drop in the number of viruses in the reservoir, which suggests a control by the immune response,” explained Sonsoles Sánchez-Palomino.

The researchers found that the patient’s blood cells were highly resistant to HIV infection in in vitro cultures, but her purified CD4+ T cells were susceptible to HIV infection. This suggests that other populations of blood cells were blocking infection and may help control HIV.

Using a viral inhibition test, the study demonstrated the existence of a strong inhibition of HIV promoted by two types of lymphocytes: natural killer cells, which are part of the innate immune system and constitute the first line of defense against various pathogens, and CD8+ T cells, which play a key role in cellular defense against viruses and bacteria. “The great novelty of the study is that we have characterized the cells that control the virus,” said Núria Climent.

In fact, these cells are responsible for what we call innate responses and correspond to memory type NK cells (natural killers) and cytotoxic T cells, so called because they are responsible for eliminating other cells. “The patient has very high levels of both cells that could block the virus or destroy the infected cells, thus obtaining functional care,” said Núria Climent. A functional HIV treatment is a much more realistic goal on a larger scale than a sterilizing treatment, which is why it is so important to understand the underlying mechanisms,” added Juan Ambrosioni.

“The case presented is exceptional, not only because there are so few people with long-term follow-up control, but also because of the control mechanism of HIV, which is different from that described in control monitors. elite and other cases documented to date. ”, explained Josep Mallolas, co-author of the communication, head of the Clínic HIV hospital unit, of the IDIBAPS AIDS and HIV Infection group and president of the Department of Medicine at UB.

This case of functional cure opens the door to the development of potential new therapeutic strategies to increase the activity of cells involved in the patient’s innate response to the virus.

Aids Agency newsroom with information

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