A patient from Sao Paulo
A person was cured of HIV for the first time with the help of drugs alone
Anatoly Glossev, Vesti
The "patient from Sao Paulo" may have become the third person in the world to be cured of HIV, and the first who did not need a bone marrow transplant for this. The unique case is reported by the journal Science. However, so far no one can guarantee that the virus will not return to the blood of the subject.
The days when the diagnosis of "HIV infection" was a death sentence are long gone. Modern antiretroviral drugs (ARVs) successfully suppress the insidious virus. In patients who pedantically take medications, the pathogen is simply not detected in the blood and, most importantly, does not have its harmful effects on the body. Therefore, today an HIV-infected person has every chance to live happily ever after.
However, there is an important "but". He will have to take medications carefully on schedule all his life. If the patient stops doing this, the virus will return to the blood in a few weeks.
The fact is that the pathogen is able to store its RNA deep in human cells. (Recall that HIV refers to viruses that do not have DNA and store hereditary information in RNA). He literally winds the thread of his RNA on the proteins of human chromosomes.
In this form, the virus does not cause any harm to the body, but it is invulnerable to drugs. And as soon as a person stops taking medications, the pathogen "comes out of the twilight" and begins its dirty business again.
There are only two known patients who managed to completely defeat the infection and get rid of the need to take medications. Both had bone marrow transplants. But it is dangerous, expensive and fraught with complications of operations. It is unlikely that it will suit 38 million people who carry an uninvited guest in their blood.
However, now there is hope that the body can be completely cleared of the virus without surgery. It was brought by a "patient from Sao Paulo," as he asks to be called for the sake of privacy.
Today this man is 36 years old. In 2012, he was diagnosed with HIV infection and started taking ARVs.
In 2015, the patient, along with four other volunteers, took part in trials of a new HIV treatment strategy. The doctors added two more medications to the usual combination of three ARVs.
At the same time, the subjects were injected with nicotinamide (vitamin B3). According to scientists, high doses of this substance cause the "sleeping" virus to activate. To completely lure the virus out of the shelter and immediately kill it with a shock dose of medications – that was the researchers' plan.
After 48 weeks of such intensive treatment, patients returned to their usual ARVP schedule and followed it for three years. Until March 2019, when the volunteers completely stopped taking antiviral drugs.
In four out of five patients, the virus quickly returned to the blood, which forced them to resume regular use of ARVs. Obviously, in their case, the researchers' strategy did not work.
But HIV has not been detected in the blood of the "patient from Sao Paulo" so far. Moreover, there are very few antibodies to this infection in his blood, that is, the immune system "does not see the enemy."
Interestingly, this patient was the only one of the five volunteers who had the virus returned to the blood against the background of high doses of vitamin B3. That is, in his case, nicotinamide seems to have fulfilled its mission: "lured the monster out of the lair."
Nevertheless, doctors are in no hurry to draw conclusions. First of all, doctors have not yet taken samples of cells from the patient's lymph nodes and intestines, where the "sleeping virus" usually hides.
In addition, history already knows examples of long-term HIV remission, which, however, ended with a new attack of the pathogen. For example, there was a case when the virus suddenly reappeared more than two years after stopping treatment.
Experts continue to study the body of the "patient from Sao Paulo" and are not yet ready for final conclusions.
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