A Woman May Have Rid Herself Naturally of HIV — But How?

By Amy Norton
Health Day reporter

TUESDAY, Nov. 16, 2021 (HealthDay News) – Researchers have identified a second HIV-positive person whose body may have cleared the infection naturally – raising hopes that studying these extremely rare events will help with treatment.

The researchers warned that they could not prove that the woman had completely eradicated the virus from her body, in what is called a “sterilizing” remedy.

But in exhaustive tests of more than 1.5 billion cells in his body, scientists could not find any genetic material of HIV capable of causing infection.

The woman, whom researchers refer to as Esperanza’s patient (after her birthplace in Esperanza, Argentina), is the second person known to have potentially recovered naturally from HIV infection.

The first case, a woman dubbed the San Francisco patient, was reported last year by some of the same researchers.

Neither woman can be declared to have undergone sterilization. All that can be said is that it is possible, according to researcher Dr Xu Yu of the Ragon Institute of Massachusetts General Hospital, MIT and Harvard, in Boston.

If both patients achieved natural healing, the big question is: how? And can this “how” become a remedy for others?

“How do we translate this to the general population of HIV positive patients? Yu said.

The Esperanza case, reported in the November 16 issue of Annals of Internal Medicine, and the San Francisco case were uncovered through ongoing research on so-called “elite controllers.”

This is a very small group of people with HIV who can control the virus without the help of standard antiretroviral therapy (ART). These drugs can suppress HIV to undetectable levels in the blood, but cannot eradicate the virus.

This is because of the nature of HIV. Its genetic material integrates into the DNA of an infected person’s cells, where it camps silently – forming what is called a latent reservoir. Antiretroviral therapy cannot erase these reservoirs, and if drugs are stopped latently infected cells can start making copies of HIV again.

Likewise, elite controllers always have detectable latent reservoirs. Although they are able to control the virus for many years, they do not eliminate it.

This is where patients from Esperanza and San Francisco stand out. The researchers found no evidence of latent reservoirs of HIV in the two patients.

“They are very, very special people who have exceptional control over the virus,” said Dr. Natalia Laufer, one of Yu’s colleagues on the study.

Now that researchers have found two of these patients, they can look for the characteristics they share, said Laufer, of the Institute for Biomedical Research on Retroviruses and AIDS in Buenos Aires.

Hopefully this will shed light on the mechanisms that allow patients such exceptional HIV control.

It is estimated that less than 0.5% of people living with HIV are elite controllers, according to Laufer. And scientists don’t yet know how they’re doing it.

Yu and his colleagues, however, gained some knowledge by using the newly developed gene sequencing technology to analyze the blood cells of elite controllers. They found that in these patients, HIV is often integrated into parts of the cell genome that are essentially “gene deserts”.

In other words, viral genetic material is sequestered away from genes that a blood cell uses to make proteins. This suggests that these infected cells are less able to make copies of HIV.

The mystery remains, however, as to how elite controllers ban HIV into gene deserts.

The “exceptional” controllers are clearly even rarer than the elite controllers. The rarity is unknown.

“We now have two cases where people seem, for all intents and purposes, to have eliminated the virus,” said Rowena Johnston, vice president and director of research for amfAR, the Foundation for AIDS Research. “How many of these people are there? It’s impossible to believe that there are only two, and these researchers have found both.”

Johnston, who was not involved in the research, pointed out “the two fundamental questions” presented by these cases: What are the mechanisms for such exceptional control of HIV? Can we translate them into a cure?

Ultimately, Johnston noted, experts believe it will take “many approaches” to cure HIV.

At this point, only two people with HIV have been declared “cured”, both after receiving stem cell transplants to treat cancer. The stem cells harbored a rare genetic mutation that protects against HIV.

Yu said the two patients with possible natural remedies offer “hope” that a widely applicable remedy can be accomplished.

More information

The US National Institutes of Health has more information on finding a cure for HIV.

SOURCES: Xu Yu, MD, associate professor of medicine, Harvard Medical School and group leader, Ragon Institute of MGH, MIT and Harvard, Boston; Natalia Laufer, MD, PhD, researcher, Institute for Biomedical Research on Retroviruses and AIDS, University of Buenos Aires, Argentina; Rowena Johnston, PhD, vice president and chief research officer, amfAR, New York; Annals of Internal Medicine, November 16, 2021, online

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