Tuesday, December 5, 2023

How Many People Have Been Cured Of Hiv

Symptoms Of Hiv Infection

Second Patient Has Been Cured of HIV

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.

Will There Ever Be A Cure For Hiv

Researchers and scientists believe we can find a cure for HIV. We know a lot about HIV, as much as certain cancers. Scientists are researching two types of cure: a functional cure and a sterilising cure.

There is no ‘natural cure’ or ‘herbal cure’ for HIV. Antiretroviral treatment is the only medication that is proven to effectively control HIV.

Promising New Research May Soon Help Treat And One Day Cure The Chronic Disease

Just over a decade ago, researchers announced a first: They had cured a patient of HIV. Known as the Berlin patient, Timothy Ray Brown had needed a bone marrow transplant to treat his acute myeloid leukemia. Doctors used the opportunity to replace his bone marrow using stem cells from a donor with gene-based HIV immunity. It worked: Browns leukemia was cured, as was his HIV. More recently, in 2019, a second patient, this time being treated for Hodgkins lymphoma, was similarly cured in London.

But although these are the most famous stories where patients have been cured from HIV, their treatments represent just one option of many new approaches for tackling the virus and one of the least widely applicable. Its too invasive and too risky to conduct a bone marrow transplant on someone who doesnt already have cancer that requires the procedure especially considering most patients with an HIV diagnosis and access to care can effectively control the disease with drugs. In fact, a patient on antiretroviral therapy, or ART, today has the same life expectancy as a person without HIV.

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What Does All This Mean

Aside from the advancements in cure research the truth is we already have highly effective antiretroviral treatment that is giving people living with HIV the opportunity to live a near-normal life.

While this already an amazing achievement, theres more to be done to improve the lives of people living with HIV including combatting stigma, reducing pill burdens and removing sexual taboos. Cure research is just one of the ways that we can move the HIV response forward.

Putting This New Report In Context

Is there a cure for HIV? What to know

The race for an HIV cure has been a long, gradual, and often frustrating process.

Dr. Steven Deeks, a professor of medicine in residence at the University of California, San Francisco and a faculty member in the division of HIV, infectious diseases, and global medicine at Zuckerberg San Francisco General Hospital, wrote in an email to Healthline that these cases provide proof that a cure is at least feasible.

When asked to clearly define what a sterilizing cure even is, Deeks wrote that, in contrast to the Berlin and London patients, these apparent cures occurred via a natural immune response.

If we can figure out the mechanism, we may be able to come up with novel therapies that take advantage of our own defense system, one that is far safer than the bone marrow transplants that led to the previous cures, he wrote.

Dr. Hyman Scott, MPH, the clinical research medical director at Bridge HIV and an assistant clinical professor of medicine at UCSF, told Healthline its necessary to frame this report in a way to make it clear it isnt a sign of a foolproof cure.

Scientists are still unclear exactly how these two womens bodies may have rid themselves of the virus.

If those pieces can be replicated, maybe there will be a strategy down the line for vaccination, for a combination of vaccination and medication, or a combination of multiple vaccinations and multiple medications. Maybe that might be a road map, he said.

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How Many People Have Been Cured Of Hiv

This article is cross posted from A& U Magazine’s Destination: Cure.

Several months ago a media frenzy . During this time, countless individuals discontinued their HIV medication, believing the cure would soon be available.

With the recent flurry of HIV “cure” reports, it’s becoming increasingly more difficult to sort out who’s actually been cured and what stories are media hype, wishful thinking, or premature reports of success.

Most people recognize headlines depicting cures in the form of herbal remedies or drugs yet to be tested in a single human being as either media hype or outright rubbish aimed at selling newspapers, stock or a product.

But what about the cases we hear announced at respected scientific conferences that sound completely realistic? How many of the cases of “functional cures” we’ve celebrated over the past three years are really actual cures?

Several of these cases come complete with a wake of conflicting reports and opinions creating confusion as to their merit.

In my black-and-white way of thinking it seems an obvious enough question to ask who, by scientific standards, is actually cured?

I posed this question to several HIV researchers and cure activists and received many different answers. This is really not surprising as the in-depth parameters of exactly what defines a cure are not all that clearly outlined.

Currently there are two types of HIV cures. They’re defined by the International AIDS Society as follows:

Stem-cell transplants:

Animal Models Of Control

The role of humanized mouse models in cure research is still evolving. Recent studies showing similar effects of latency-reversing strategies in mice and the less scalable nonhuman primate model are encouraging,. Given that access to nonhuman primates for cure studies will likely remain a barrier, ongoing optimization, standardization, and validation of mouse models should be prioritized.

An important discrepancy in translating cure-related findings from SIV-infected nonhuman primates to people with HIV lies in the duration of ART. Although effective ART regimens with integrase inhibitors have been optimized in nonhuman primates, high costs, and treatment-related toxicities necessitate relatively shorter study durations . One possible solution would be for primate research centers to maintain colonies of SIV-infected nonhuman primates receiving very-long-term ART to be directly assigned for studies.

A major recent advance has been the development of genetically barcoded SIVmac239 strains. Because the barcode tags are easily quantified and also passed on to progeny virus, this model allows for tracking of clonal dynamics, providing more precise insights into how interventions affect seeding of the reservoir, viral reactivation during ART, or viral recrudescence after ART interruption.

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Most Popular From Time

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.

What Is An Hiv Cure

Man possibly cured of HIV: Report

There are two different visions of a potential HIV cure: treatment-free remission and viral eradication.

Treatment-free remission means the virus is controlled without the need for ART drugs, which a person has to take every day for life. Millions of people who have HIV canât afford ART, so other treatments are needed. This idea of an HIV cure is also called a functional cure.

Treatment-free remission means that youâd:

  • Live a healthy life thatâs of normal length
  • Not have to take ART or any other HIV-related drugs to keep the virus under control
  • Not be able to pass on HIV to others

Many therapies are being studied as a way to control HIV without the need for daily ART. These include antibody therapies and therapeutic vaccines. They donât prevent infection, but stimulate your own immune system to fight it.

Viral eradication is another way of looking at a potential cure. Itâs also known as a sterilizing cure. Scientists believe it would take a two-part treatment to wipe out HIV in a personâs body. The first part would involve drugs that make the cells in the HIV reservoir multiply and express proteins that are a like a signal to your immune system. The second part would include drugs that detect those protein signals, then seek out and kill the virus.

Other types of drugs that may be able to seek out and kill HIV include histone deacetylase inhibitors, protein kinase activators, latency securing agents, and immunotoxins. These drugs may be used in combination.

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‘i Enjoy Being Healthy This Is A Privilege: ‘ Woman Who Is Second Person In The World To Be ‘naturally’ Cured Of Hiv Without The Help Of Treatments Says She Is Grateful To Be Virus

  • A woman from Argentina who is the second patient in the world to be ‘naturally’ cured of HIV said it is a ‘privilege’ to be naturally cured of the virus
  • The woman, called the ‘Esperanza Patient’ after the city where she lives, was identified by scientists in Buenos Aires and at the Ragon Institute
  • She’s the second patient that the Ragon Institute has identified as potentially cured – in over one billion cells of her body, no HIV genetic material was found
  • Studies suggest about 0.5% of HIV-infected people have uniquely strong immune responses to the virus, out of 38 million living with it worldwide
  • If scientists can identify the secret behind these patients’ natural resistance to HIV, they can leverage it for new treatments – even a potential cure

New Hiv Diagnoses In The Us And Dependent Areas By Transmission Category 2019

NOTE: Does not include other and perinatal transmission categories.

Source: CDC. Diagnoses of HIV infection in the United States and dependent areas, 2019. HIV Surveillance Report 2021 32.

If we look at HIV diagnoses by race and ethnicity, we see that Black/African American people are most affected by HIV. In 2019, Black/African American people accounted for 42% of all new HIV diagnoses. Additionally, Hispanic/Latino people are also strongly affected. They accounted for 29% of all new HIV diagnoses.

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Second Patient Cured Of Hiv Say Doctors

Health editor, BBC News online

A man from London has become the second person in the world to be cured of HIV, doctors say.

Adam Castillejo is still free of the virus more than 30 months after stopping anti-retroviral therapy.

He was not cured by the HIV drugs, however, but by a stem-cell treatment he received for a cancer he also had, the Lancet HIV journal reports.

The donors of those stem cells have an uncommon gene that gives them, and now Mr Castillejo, protection against HIV.

In 2011, Timothy Brown, the “Berlin Patient” became the first person reported as cured of HIV, three and half years after having similar treatment.

The Berlin Patient: How Doctors Used A Stem Cell Transplant To Clear Hiv

Monthly HIV Injection Treatments Could Soon Become Available

To understand the case of the London patient described in Nature, we need to step back and understand what happened with the Berlin patient, Timothy Ray Brown, the only person believed to be cured of HIV.

An American living in Berlin, Brown found out he had leukemia in 2006, 11 years after an unrelated diagnosis of HIV. Like many people living with HIV today, Brown used antiretroviral treatments to suppress the virus to the point that it was undetectable.

But his cancer wasnt as easy to manage. For treatment, Brown was referred to Charité Medical University in Berlin, and to a blood cancer doctor, Gero Hütter. Because Browns leukemia had stopped responding to chemotherapy, Hütter recommended an allogeneic stem cell transplant as the next step.

Leukemia is a blood and bone marrow cancer, and allogeneic transplants involve wiping out the immune system with chemotherapy and replacing it with donor hematopoietic stem cells. These cells are typically found in the bone marrow, and they produce blood and immune system cells. The idea is that the new cells from a cancer-free donor will regenerate the recipients immune system, clearing the patient of malignant cells.

Instead of just looking for a donor who was a tissue match, though, Hütter had a novel idea: find someone who also carried whats called a CCR5-delta 32 mutation.

More than a decade on, Brown, who is 52 and now lives in Palm Springs, California, remains clear of the virus.

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How Many People Have Been Cured Of Hiv One

Several reports being presented to coincide with an international AIDS conference this week may at first raise hopes that it could be possible to cure HIV infection. But two other major developments make it clear that its pretty much back to the drawing board for researchers trying to find a way to thwart the virus.

In one report, researchers at St. Vincents Hospital and the Kirby Institute in Sydney, Australia, say two men who got bone marrow transplants to treat their cancer appear to be free of the virus. In another, Canadian researchers say four babies treated right after birth show no sign of the virus, either.

Characterization Of The Complete Hiv Reservoir

HIV DNA can be detected in CD4+T cells in blood and lymphoid tissue in nearly all people with HIV on ART. These viral genomes are mainly defective. Only a small proportion appear to be intact and potentially replication-competent. But the HIV reservoir goes beyond circulating CD4+T cells it also includes tissue-resident CD4+T cells and cells of the monocyte/macrophage lineage, further complicating efforts to characterize and quantify it. In vitro, HIV preferentially integrates into transcriptionally active genes however, in people with HIV on ART, many proviruses , including intact ones, have been identified in genomic regions that are silent , which limits or precludes their reactivation.

Fig. 1: Multidimensional nature of the HIV reservoir.

The HIV reservoir can be defined across a number of dimensions, including: anatomical and microanatomical locations, cell type , cell functional profile , pool of proviruses with a particular functional profile or triggering event , and integration-site features of the rebounding virus.

Biological sex can influence HIV pathogenesis, the immune response to HIV infection, and response to antiviral therapy. Furthermore, in some but not all studies, womens reservoirs have been shown to be less transcriptionally active and less inducible than those of men,,,,. Sex, therefore, is a critical variable that should be considered as new therapies to target the reservoir are developed.

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Treatment Reduces The Amount Of Hiv In The Blood

  • The amount of HIV in the blood is called viral load.
  • Taking your HIV medicine as prescribed will help keep your viral load low and your CD4 cell count high.
  • HIV medicine can make the viral load very low . Viral suppression is defined as having less than 200 copies of HIV per milliliter of blood.
  • HIV medicine can make the viral load so low that a test cant detect it .
  • If your viral load goes down after starting HIV treatment, that means treatment is working. Continue to take your medicine as prescribed.
  • If you skip your medications, even now and then, you are giving HIV the chance to multiply rapidly. This could weaken your immune system, and you could become sick.
  • Getting and keeping an undetectable viral load is the best way to stay healthy and protect others.

The Real Meaning Of Functional Cure

Second man appears to have been cured of HIV after transplant

‘Functional cure’ isn’t a cure in the traditional sense, said Michael Horberg, MD, chair of the HIV Medicine Association, a group representing doctors and other healthcare workers who treat HIV/AIDS. It just means the virus has been reduced to such low levels that it doesn’t cause harm, even without medications, though the patient still has the virus.

“The virus is still there, but as long as the viral particles in the patient’s body remain low and their T-cell count their helper cell count remains high, they won’t feel sick,” Dr. Horberg said.

Though 1 percent of the HIV-infected population is known to harbor an innate genetic immunity to HIV without the aid of treatment, scientists are hopeful that research on this new subgroup of post-early-treatment-controlled people with HIV could help others with the disease.

Specifically, researchers believe that beginning antiretroviral therapy in the early stages of HIV infection minimizes the risk that the virus will come back while helping patients maintain a strong immune system. Doctors estimate that 15 percent of those who are HIV-positive could see similar results if they are treated early.

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