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Yu cautions that the findings may not be generalizable to most HIV patients. Both of her patients belong to a group known as elite controllers, or people who are able to suppress HIV at very low, often undetectable levels with their immune systems, without the help of anti-HIV drugs. Researchers around the world are studying these people intensively its not clear what percentage of those infected with the virus are able to naturally contain it with their immune systems, but Yu believes that the two patients she described suggest that there may be more. Shes hoping that hearing about the first two will encourage others to get tested and studied, so scientists can better understand what aspect of their immune systems are providing such an effective way to block HIV.
Many immune factors could be playing a role, she says. Now that we have a second case, there are probably many cases out there that may not know they have a sterilizing cure. Some may not even be aware they are infected. We are hoping to attract more patients if we have a cohort of these extremely rare cases, then that will allow us to really analyze their immune responses in more depth and breadth and hopefully give us a hint about what immune factors contribute most to this status. Then we can apply what we learn to the general population.
The Rarest Of The Rare
The Esperanza Patient is among a rare group of people living with HIV called elite controllers. These people’s immune systems can control HIV without antiretrovirals. Most elite controllers’ immune systems, however, can’t mount the immune attack necessary to eliminate all replicating HIV from their systems. Instead, their immune systems control the virus without affecting the reservoirs where HIV continues to make copies of itself and can spread.
The Esperanza Patient and Willenberg, however, appear to be the rarest of the rare. Their own immune systems seem not only to have stopped HIV replication outside of reservoirs but also to have stormed those reservoirs and killed all virus that might have continued to replicate.
The two women are connected in another way: At an HIV conference in 2019, Yu was presenting data on Willenberg’s case. At that conference, she met Natalia Laufer, MD, PhD, associate researcher at the Instituto de Investigaciones Biomédicas en Retrovirs y SIDA at the University of Buenos Aires. Laufer had been studying the Esperanza Patient at the time and asked Yu whether she and her team at the Ragon Institute could help her sequence the patient’s HIV genome to see whether, indeed, the virus had been spontaneously cleared from the patient’s system.
How Long Can Hiv Survive On Surfaces
Lets look at the evidence available to us.
- HIV is killed by heat. Temperatures of above 60C will kill HIV.
- HIV is NOT killed by cold. In fact, colder temperatures increase the survival time of HIV.
- At 27C to 37C, HIV can survive up to 7 days in syringes
- At room temperature, HIV can survive in dried blood for 5 to 6 days
- At 4C, HIV can survive up to 7 days in dried blood
- At -70C, HIV can survive indefinitely
- HIV can only survive in pH between 7 and 8
- HIV has been found to survive for a few days in sewage
- HIV has been found to survive in organs and corpses for up to 2 weeks
You would notice that all these studies are done on blood. There is really no good evidence to determine how long HIV from semen, vaginal secretions of other body fluids can survive outside the body. One fact is that it is very difficult to culture HIV from semen. This indicates the low viral content and we can assume that the same timelines for blood apply to semen if not less.
In these experiments, the survivability of the HIV virus is determined by its retention of the ability to infect cells in cell culture.
We must be careful not to equate survivability to infection.
In other words:
- HIV infected surface/fluid + broken skin HIV infection
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How Long Does Hiv Survive Outside The Body
In general, the virus doesnât live long once itâs outside of a human body. Studies show that HIV grown in the lab, when placed on a surface, loses most of its ability to infect — 90% to 99% — within several hours. And the level of virus tested was much higher than whatâs found in bodily fluids. So contact with dried blood, semen, or other fluids poses little risk.
One study found HIV can live in used needles for over a month if the temperature and conditions are just right. That means sharing needles or syringes, like during drug use, raises your risk of infection.
Symptoms Of Hiv Infection
Most people experience a short flu-like illness 2 to 6 weeks after HIV infection, which lasts for a week or 2.
After these symptoms disappear, HIV may not cause any symptoms for many years, although the virus continues to damage your immune system.
This means many people with HIV do not know they’re infected.
Anyone who thinks they could have HIV should get tested.
Some people are advised to have regular tests as they’re at particularly high risk.
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Frequently Asked Questions About Hiv/aids
HIV can be detected in several fluids and tissue of a person living with HIV. It is important to understand however, that finding a small amount of HIV in a body fluid or tissue does not mean that HIV is transmitted by that body fluid or tissue. Only specific fluids from an HIV-infected person can transmit HIV. These specific fluids must come in contact with a mucous membrane or damaged tissue or be directly injected into the blood-stream for transmission to possibly occur.
In the United States, HIV is most commonly transmitted through specific sexual behaviors or sharing needles with an infected person. It is less common for HIV to be transmitted through oral sex or for an HIV-infected woman to pass the virus to her baby before or during childbirth or after birth through breastfeeding or by prechewing food for her infant. In the United States, it is also possible to acquire HIV through exposure to infected blood, transfusions of infected blood, blood products, or organ transplantation, though this risk is extremely remote due to rigorous testing of the U.S. blood supply and donated organs.
For more information, see: How safe is the blood supply in the United States?
For more information on latex condoms, see “Male Latex Condoms and Sexually Transmitted Diseases.”
Risk for HIV infection increases if you or a partner has a sexually transmitted disease .
For more information on latex condoms, see “Male Latex Condoms and Sexually Transmitted Diseases.”
How Long Does Hiv Live Outside The Body
There are many myths and misconceptions about how long HIV lives and is infectious in the air or on a surface outside the body.
Unless the virus is kept under specific conditions, the true answer is not very long.
Although it causes a serious disease that cant be cleared by the body, HIV is very fragile in the outside environment. It quickly gets damaged and becomes inactive, or dies. Once inactive, HIV cant become active again, so its the same as if its dead.
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Ways Hiv Is Not Transmitted
How well does HIV survive outside the body?
HIV does not survive long outside the human body , and it cannot reproduce outside a human host. It is not transmitted
- Through saliva, tears, or sweat.
- Through other sexual activities that dont involve the exchange of body fluids .
- Through the air.
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Once Again About Hiv: What This Disease Is How To Get It And How To Avoid It
Human immunodeficiency virus is a retrovirus that suppresses the human immune system by integrating into the DNA of a human cell and blocking its protective functions.
When HIV enters the bloodstream, it attaches to the blood cells that are responsible for immunity, and the active reproduction of HIV begins. Throughout the period of the disease there is no effective response to the presence of HIV. This can be mainly explained by the fact that immune cells are damaged and cannot function properly. HIV is characterized by the absence of pronounced and characteristic symptoms and it is possible to find out about the presence of HIV infection in the body only after passing an HIV test.
In the external environment, HIV is not stable: at a temperature of 56 ° C it dies in 30 minutes, when boiled – instantly. The virus dies quickly when using disinfectants, under the influence of 20% ethanol, ether, acetone, 0.2% sodium hypochlorite, 1% glutaraldehyde. However, it is resistant to ionizing radiation, ultraviolet radiation. In the blood intended for transfusion, the virus lives for years, and in frozen serum its activity persists for up to 10 years.
Ways of HIV transmission:
How it is impossible to get HIV:
What protects against infection ?:
- the presence of a permanent sexual partner
- avoid casual sex . This will protect not only from HIV, but also from sexually transmitted infections, hepatitis B and C
- use of individual syringes, needles.
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The Argentinian Is The Second Known Person Whose Immune System May Have Eliminated All Viable Virus From Her Body
A 30-year-old Argentine woman appears to have become the second documented person whose body may have eliminated her HIV on its own, a study says.
Scans of more than 1 billion of the womans cells detected no viable virus, even though for most of the time she was not undergoing antiretroviral therapy meant to keep the virus from replicating. The finding raises the possibility that a persons own immune system may in rare cases provide a sterilizing cure the elimination of virus capable of copying itself the researchers wrote.
What happened is unique, said Steven Deeks, an HIV researcher at the University of California at San Francisco, who was not involved in the study. Its not that shes controlling the virus, which we do see, but that theres no virus there, which is quite different.
The study, published Monday in the Annals of Internal Medicine journal, contributes to research with major implications for the 37.7 million people worldwide living with HIV, which can lead to AIDS if left untreated. HIV spreads through bodily fluids, usually after unprotected sex or needle-sharing.
While HIV has no known cure, the virus has been eliminated in three people who received stem cell transplants to treat their cancer. But transplants are dangerous and frequently fraught with complications, making them unrealistic tools for curing a disease that can be treated with a daily pill regimen and a recently approved injection.
Heres Evidence From Investigated Outbreaks
Investigations of HIV outbreaks from unsafe health care provide other evidence about patients risks to get HIV from skin-piercing instruments. In Elista, Russia, in 1988-89, for example, hospitals spread HIV from 1 to more than 260 children within 15 months . For HIV to go from 1 to 260 children in 15 months, the number of infections had to double 6 times doubling on average every 2.5 months. To get to 260 infections in 15 months, each HIV-infected child had to, on average, infect another every 2.5 months. If the risk to transmit HIV through contaminated equipment was 0.3%, an HIV-positive patient would have to have, on average, more than 300 skin-piercing procedures after which equipment was reused without sterilization for HIV to go from him or her to another patient. That would take years, not just several months. Similarly, in Roka Cambodia, HIV went from 1 to 198 patients in an estimated 15 months .
Clearly, in these investigated outbreaks the risk to transmit HIV through reused and unsterilized instruments was much greater than 0.3%. If an HIV-positive person in Russia got an average of 10-50 skin-piercing procedures before HIV reached and infected someone else, then the risk to transmit would be 2% to 10% . These are crude estimates but certainly more realistic that the widely reported 0.3%.
Table: Risk to get HIV from HIV-contaminated skin-piercing instruments
|Skin-piercing procedures with unsterilized instruments
|Hair straightening, styling
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Second Woman Spontaneously Clears Hiv: ‘we Think More Are Out There’
It sounds like a fairy tale steeped in HIV stigma: A woman wakes up one morning and, poof, the HIV she’s been living with for 8 years is gone. But for a 30-year-old Argentinian woman from the aptly named village of Esperanza, that’s close to the truth, according to an article published in Annals of Internal Medicine.
The woman, the so-called Esperanza Patient, appears to be the second person whose immune system cleared the virus without the use of stem cell transplantation. The first was Loreen Willenberg, a California woman who, after living with HIV for 27 years, no longer had replicating HIV in her system. That case was reported last year.
“That’s the beauty of this name, right? Esperanza,” said Xu Yu, MD, principal investigator of the Ragon Institute of Massachusetts General Hospital, the Massachusetts Institute of Technology, and Harvard University, Boston, Massachusetts, referring to the Spanish word for “hope.” “This makes us hopeful that a natural cure of HIV is actually possible.”
Two other people appear to have cleared HIV, but only after full replacement of the immune system via stem cell transplantation the Berlin Patient, Timothy Ray Brown, and the London Patient. Another man, from Brazil, appeared to have an undetectable viral load after receiving intensified antiretroviral treatment plus supplemental vitamin B3.
Where Did Hiv Come From
Since scientists first became aware of HIV in the early 1980s, they have explored how and where the disease originated. While there are many theories, the most scientifically supported theory has traced the roots of the most common type of HIV to a virus found in a subspecies of chimpanzees in Africa. It is now generally accepted that HIV is a descendant of this virus. It is believed that the virus was transferred to humans as a result of chimpanzees being killed and eaten or their blood getting into cuts or wounds of people during the hunting process.
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Hiv In Vaginal Fluids
While HIV can spread via vaginal fluids, the virus tends to exist in smaller concentrations than it does in blood and semen.
It is not clear why this is the case, but it appears that hormones and the types of cells in the genital tract may play a role.
Breast milk contains HIV in lower concentrations than blood or semen.
A baby can contract HIV through breast milk, so the CDC recommend that people with HIV do not breastfeed, regardless of antiretroviral therapy or viral load.
HIV can also transmit to a baby through pregnancy or birth. However, this is becoming less common with recent developments in care.
If a person with HIV is receiving effective antiretroviral therapy, and they give HIV medicine to the baby for 46 weeks after delivery, the risk of the baby contracting HIV can be
Heres Evidence From Needlestick Accidents
A summary of 23 studies reported 3 in 1,000 healthcare workers exposed to HIV through needlesticks got HIV. From such data, many people including health experts who should know better say the risk to get HIV after an injection with a contaminated syringe or needle is 0.3%. A closer look at needlestick accidents shows a much greater risk to transmit HIV through accidents that are similar to injections and other skin-piercing medical procedures.
Specifically: a 1997 study of healthcare workers who did and did not get HIV after needlestick accidents found that most accidents were shallow scratches. Only 7% were deep injuries, deep enough for the hole of the needle to be within the skin, as in an injection. The risk to get HIV after deep needlesticks was 15 times greater than for all needlesticks.
Thus, from needlestick accidents, a first approximation of the risk to transmit HIV through injections all of which fit the definition of a deep injury is 4.5% . The same study found other factors could raise or lower that risk for example, risks could be even greater if the source patient was very sick with a lot of virus, or if there was blood visible on the instrument.
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A Fossil Record Of Hiv
Yet, there was still HIV in the woman’s system. Laufer and Yu wanted to know whether that HIV was transmissible or whether it was a relic from when HIV was still replicating and was now defective and incapable of replicating. They performed extensive genome sequencing on nearly 1.2 billion cells that Laufer had taken from the patient’s blood in 2017, 2018, 2019, and 2020, an additional 503 million cells that were from the placenta of the baby she gave birth to in 2020, and 150 million resting CD4 T cells. Proviral sequencing was undertaken of the full DNA of the HIV to detect whether the virus was still intact. The DNA was then analyzed by use of an algorithm and was tested for mutations. The investigators tested the patient’s CD4 cells to determine whether the cells still harbored any latent HIV.
In this way, they conducted a full viral workup using tests that are far more sensitive than the viral load tests the woman had undergone in the clinic. The investigators then assessed the patient’s immune system to see what the various cells of the immune system could tell them about how well her natural immune system could identify and kill HIV. They isolated the Esperanza Patient’s immune cells and subjected those cells to HIV in the lab to see whether the cells could detect and eliminate the virus.
And just to be safe, they checked to make sure there were no antiretroviral drugs in the patient’s system.
In other words, they had uncovered a fossil record.