Some people's immune systems control HIV infections without drugs
"Elite controllers" keep the deadly virus in check, and hide its DNA in a quiet section of the genome.
In what could be a world first, it appears that an HIV-1 patient may have completely eradicated their body of functional copies of the virus without requiring medical treatment.
Researchers were studying a rare cohort of people known as "elite controllers," in which HIV-1 replication is suppressed by the immune system for many years. In order to better understand how this desirable control of the virus happens, researchers used advanced sequencing techniques to investigate the number of functional and non-functional copies of the virus and their location in the infected individual’s genomes.
When compared with patients receiving the standard treatment of antiretroviral therapy, elite controllers had fewer viable copies of the virus in their genome. Furthermore, the viral DNA was stored in naturally inactive parts of the genome, rendering the virus mostly inert.
The researchers also made another exciting finding: a patient known as "EC2" who had previously tested positive for HIV-1 appeared to have no functional copies of the virus despite analysis of over 1.5 billion of their cells. Provided viable virions are not lurking elsewhere, this could be the first instance of a natural cure.
Until now, cures came in the form of gruelling bone marrow transplants in the case of the "Berlin patient" and the "London patient" who simultaneously dealt with cancers. The Berlin patient, Timothy Ray Brown, was free from HIV for 13 years before he died in September of related leukemia.
This step forward in the understanding of elite controllers could help researchers developing therapies for the treatment of HIV-1, also highlighting that in some rare cases the immune system may be able to deal with the viral infection on its own.