Brazilian HIV Patient May Become First to Go Into Remission Without Transplant

A man who contracted the human immunodeficiency virus (HIV) several years ago and has gone into remission may become the first patient to be essentially cured of the disease without requiring a bone marrow transplant, researchers revealed Tuesday.
Sputnik

The 34-year-old Brazilian was diagnosed with HIV in 2012 and was treated in the last few years with a multi-drug cocktail of antiretroviral therapy, which included maraviroc and dolutegravir, as well as a drug called nicotinamide, which is a form of vitamin B3. 

On Tuesday, researchers revealed that after a 48-week course of the drug cocktail, the man has gone more than 57 weeks without the treatment and continues to test negative for HIV antibodies.

"This case is extremely interesting, and I really hope that it may boost further research into an HIV cure," Andrea Savarino, a doctor at Italy's Institute of Health who co-led the trial of the drug cocktail, recently said in an interview with the UK charity NAM AIDSmap, Reuters reported.

Ricardo Diaz, an infectious diseases expert at the University of Sao Paulo, who was also involved in the trial, revealed that the results suggest the patient may be cured of HIV. 

“The significance for me is that we had a patient that was on treatment and he is now controlling the virus without treatment,” he told AFP. “We’re not able to detect the virus and he’s losing the specific response to the virus - if you don’t have antibodies then you don’t have antigens.” 

The presence of antigens such as bacteria or viruses in the body typically induces a response from the immune system, which generates antibodies against various threats.

However, Savarino also noted that four other HIV-positive patients in the trial who were treated with the same drug cocktail have not seen any improvements and are still testing positive for HIV antibodies.

"The result is highly likely not to be reproducible. This a very first (preliminary) experiment, and I wouldn't foresee beyond that,” Savarino warned.

American citizen Timothy Brown is the first person to have been cured of HIV. He is often referred to as the “Berlin Patient,” because he was diagnosed with the virus in 1995 while studying in Berlin, Germany. Brown was cured from HIV after he underwent a 

hematopoietic stem cell transplantation to treat his leukemia in 2007. The procedure involves the transplantation of multipotent stem cells usually derived from bone marrow, peripheral blood or umbilical cord blood.

Last year, Adam Castillejo, also known as the “London Patient,” was cured of HIV after receiving a bone marrow transplant for his cancer of the lymphatic system, also known as lymphoma. The bone marrow donor had a genetic mutation called delta 32, which makes blood cells immune to HIV by blocking the virus from attaching to them. By receiving the donor’s bone marrow, Castillejo’s immune system was effectively replaced with one that is HIV-resistant, as most of the body’s blood cells, including the white blood cells that fight infections, are produced in the bone marrow.

As scientists try to find a cure or vaccine for COVID-19, researchers are still looking for a cure for HIV, which has infected more than 75 million people since the 1980s. 

According to the US Centers for Disease Control and Prevention (CDC), there were about 1.7 million new cases of the illness globally in 2018. Out of the 37.9 million people living with HIV in 2018, around 24.5 million of them were taking antiretroviral therapy to treat the disease.

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