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The anomalous case of a patient opens up new avenues of research against AIDS- Corriere.it

from Silvia Turin

A Spanish woman only received the drugs in 2006 and, although she still has the virus in her body, the viral load is turned off. Researchers have identified the mechanism that helps it and want to replicate it on others

Two new cases were presented on Wednesday at International AIDS Conference underway in Montreal: that of a man with cancer who underwent HIV-resistant stem cell transplantation from donor and cured and the other of a woman who, after receiving immune-boosting therapies in an HIV clinical trial, he has lived for 15 years without drugs and with an undetectable viral load.

The bone marrow transplant

The latest cured from the virus through a stem cell transplant (needed to deal with a blood cancer) is a 66-year-old American man, the oldest who has stopped taking drugs. The approach, which has proven successful in other cases
uses stem cells from a donor with a specific rare genetic abnormality that gives rise to immune cells naturally resistant to the virus. The man received the transplant 3 and a half years ago and for 17 months his antiretroviral treatment for HIV was suspended. Two other people were considered cured of HIV in this way: they are Timothy Ray Brown, the Berlin patient (born 1966) and the London patient (now 42 years old). Both had received HIV-resistant bone marrow stem cell transplantation.

Transplant cannot cure 40 million people

The bone marrow transplants for are expensive and they can involve very important side effects: cannot be a cure for i 40 million of people around the world who still live with the AIDS virus. And, for that matter, other people who have received a bone marrow transplant they did not break free from infection.

Mechanisms involved in remission identified

This is why the case of the woman who has lived without drugs for 15 years is so interesting:Hospital Clnic of Barcelona, ​​as reported by the newspaper El Pais, they managed to understand the innate characteristics in the immune system of the lady that allowed her to keep the disease at bay and defeat parts of the virus in your body Year after year. The lady, whose identity is unknown (but she is 59 years old), contracted the acute infection in 2006 and was then chosen together with 20 other patients for drug treatment. she was the only one in the group to pass more than 50 viral load tests over the next 15 years. The novelty of the research conducted over the years on her immune system that it was possible to characterize which subpopulations of the immune system were involved in the peculiar process defense against HIV: are the Natural Killer cells that have memory and also others called Gamma-Delta T, those that provide innate immunity. The patient has very high levels of both. a mechanism never before observed in other subjects which also control the disease (very few). Not only. Over the years the The lady’s viral tank is shrinking and there may come a time when it reaches zero.

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A remission different from all cases

The case of Barcelona different from other cases of healing known and mentioned (there is also the patient of São Paulo, free from the HIV virus thanks to a cocktail of drugs and not thanks to bone marrow transplants): in the case of the lady when the cells are analyzed, there is still viable virus capable of causing new infections. Patients who have used bone marrow transplant, on the other hand, have it completely deleted the virus from your body.
The next step in the Spanish research will be to identify exactly which combination of patient-specific factors, together with those induced by the drugs received in 2006, led to these results. The hope replicate conditions for othersso that, although they cannot be cured, they can live without drugs, with an undetectable viral load and without the possibility of being contagious for many years.

July 27, 2022 (change July 27, 2022 | 18:59)

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