- Researchers have reported that a woman living with HIV in Argentina is now the second person whose body seemingly rid itself of the virus. She was diagnosed with HIV in 2013.
- Researchers found that she might potentially be an “elite controller” of the virus, showing no signs of active HIV infection in the 8 years since her diagnosis.
- Current testing has been unable to detect the presence of HIV in her cells.
- Though these findings are promising, researchers are still unsure exactly how this occurred within her body. They were clear this is not a definitive cure for HIV.
- However, it could lead to potential treatment breakthroughs in the near future.
Earlier this month, news came out that a woman in Argentina reportedly became the second known person in the world whose immune system had apparently “cured” her HIV.
The report came from published research in the Annals of Internal Medicine by a team of scientists who see this case as opening a window to potential breakthroughs down the line in the continued hunt for an HIV cure.
What do these rare, isolated examples of potential HIV cures say about our understanding of the virus 40 years after the start of the public health crisis that’s seen 36.3 million people die from AIDS-related illnesses globally?
Is an HIV-free world within reach?
This most recent case of a natural HIV “cure” centers on a 30-year-old woman first diagnosed with HIV in 2013.
“I enjoy being healthy,” said the woman known as “the Esperanza patient,” who spoke on condition of anonymity to NBC News. “I have a healthy family. I don’t have to medicate, and I live as though nothing has happened. This already is a privilege.”
In the new paper spotlighting the Esperanza patient (named after the Argentinian town in which she lives), researchers found that the woman might potentially be an “elite controller” of the virus.
She shows no signs of active HIV infection in the 8 years since her diagnosis. Current testing has been unable to detect the presence of HIV in her cells.
She was not a recipient of a regular regimen of antiretroviral treatments. The only time she received antiretroviral medications was for 6 months in 2019 when she became pregnant.
During that brief period, she took the drugs tenofovir, emtricitabine, and raltegravir during her second and third trimesters, according to CNN.
The Esperanza patient is just the second person reported to have possibly staved off the virus naturally — ultimately erasing any signs of active HIV — without the assistance of medical therapies like stem cell transplants.
The first was a woman from California, Loreen Willenberg, who is now 67 years old. She was diagnosed with HIV in 1992, and her immune system apparently performed the same function of naturally eliminating HIV.
Beyond these two cases, scientists reported curing two other people, called the “London and Berlin patients,” through stem cell treatments.
Timothy Ray Brown, the aforementioned “Berlin patient” and first person reported to be cured of HIV through stem cell treatments, died at 54 of leukemia in 2020, according to the International AIDS Society.
The race for an HIV cure has been a long, gradual, and often frustrating process.
Dr. Steven Deeks, a professor of medicine in residence at the University of California, San Francisco (UCSF) and a faculty member in the division of HIV, infectious diseases, and global medicine at Zuckerberg San Francisco General Hospital, wrote in an email to Healthline that “these cases provide proof that a cure is at least feasible.”
When asked to clearly define what a “sterilizing cure” even is, Deeks wrote that, in contrast to the Berlin and London patients, “these apparent cures occurred via a natural immune response.”
“If we can figure out the mechanism, we may be able to come up with novel therapies that take advantage of our own defense system, one that is far safer than the bone marrow transplants that led to the previous cures,” he wrote.
Dr. Hyman Scott, MPH, the clinical research medical director at Bridge HIV and an assistant clinical professor of medicine at UCSF, told Healthline it’s necessary to frame this report in a way to make it clear it isn’t a sign of a foolproof “cure.”
Scientists are still unclear exactly how these two women’s bodies may have rid themselves of the virus.
“What this case and some of the other cases hopefully give us are insights into a potential road map to replicate this. Look, this might be such a special one, a 1-in-8 billion case, but it might give us an idea of what are the pieces that need to be in place that allow something like this to be possible,” Scott said.
“If those pieces can be replicated, maybe there will be a strategy down the line for vaccination, for a combination of vaccination and medication, or a combination of multiple vaccinations and multiple medications. Maybe that might be a road map,” he said.
Essentially, Scott said cases like that of the Esperanza patient could give us small puzzle pieces to “work backwards from,” using science to better understand how we can fill in gaps of knowledge we have about the virus.
“This does give us real energy to think about what is possible, or might be possible,” Scott added.
We certainly have made incredible strides in HIV treatment.
A cure might not be here right now, but improvements in antiretroviral therapies mean people living with HIV can attain “undetectable” status when they adhere to regular treatment.
Undetectable status means the viral load in a person’s body can be suppressed to such low numbers that they will not transmit the virus to sexual partners.
It also means these people can live long, healthy lives, taking what was once a death sentence during the height of the HIV crisis and making it a manageable, chronic condition.
Of course, as with most aspects of healthcare, inequities persist.
Those who are often affluent, white, or live in areas with pervasive and effective targeted public health messaging will most likely have the most resources to embrace these efforts.
As with all aspects of the continued HIV crisis, more can be done, and more can be done better.
Scott explained that COVID-19 has presented us with a pathway for how to use science to tackle a virus that fuels a pandemic: You can create a vaccine that triggers an immune response that’s similar to what happens when someone is recovering from that infection.
He added that HIV functions differently. It integrates into a person’s genome and “gets integrated into these very long-lived cells that can be activated even if the viral load is undetectable, when it’s still in that dormant state in the body.”
“So, there hasn’t really been an effective strategy to remove cells that are in that ‘dormancy,’ so to speak, of HIV that would allow somebody to become functionally ‘cured’ or in ‘extended remission,’ which is some of the terminology that has been used for this,” Scott said.
“So, in short, we don’t really have a great sense of what type of response in the immune system would allow somebody to achieve that state,” he said.
In regard to the Esperanza patient, Deeks wrote that the data from the new report suggests that her “immune response did what it had to do very early in the infection, before a complete antibody response emerged.”
Deeks believes this has implications for a better understanding of our body’s own immune responses to viruses like HIV.
“It suggests those parts of our immune system that are designed to react immediately to an infection are going to be key to figure out how to come up with an effective cure,” he wrote.
If anything, nearly 2 years of living through a pandemic that has affected every single person’s life, and approach to the health of themselves and those around them, has put a bigger magnifying lens on public health and how we combat viruses.
Scott said one example is recent advancements in hepatitis C treatment and research that better clarifies how the body can combat the virus.
Whether it’s the coronavirus, hepatitis C, or HIV, we are in an era where more resources, energy, and innovation are all being directed to tackle health threats that affect millions of people worldwide.
What significance does studying the Esperanza patient have on moving down the long road to a cure for HIV?
“These anecdotes are very impactful,” Deeks wrote. “They provide the proof that a cure is possible, and the inspiration for the field to stick with what most assume is going to be a long road to finding an effective, safe and scalable cure.”
Scott reiterated that we must be clear we don’t have a definitive cure for HIV after these cases.
It could be on the horizon, but we’re not there yet.
“The authors [of the paper] do a good job of framing that this does not mean that this patient has definitely developed a sterilizing cure for the HIV. It means that they are not able to find HIV that is replicating with these tests, so I think we do need to be careful,” he said.
“We can be excited and careful, excited and cautious how we interpret these findings. It hopefully will give us new insights into what might be possible for our holy grail of some sorts to find a cure for HIV,” Scott said.