How far are we from a complete cure for HIV?

  A group of British scientists and doctors released news about the second HIV-positive man in London. After receiving treatment for Hodgkin's lymphoma, he has been infected with HIV for a long time (18 months). This unexpected success sparked a new debate on AIDS treatment

  Since 2008, scientists have been working hard to create a cure for HIV for "patients in Berlin". At that time, many people in the field of HIV research were excited to realize that this person seemed to be able to cure his HIV. In Berlin, he tested positive for the human immunodeficiency virus and recently received treatment for acute myeloid leukemia. So far, the success of replicating this therapy has been limited.

  What is HIV? HIV is a virus that causes AIDS. Since HIV was first discovered in the 1980s, more than 75 million people worldwide have been infected with HIV. Today, about 37 million people are infected with HIV. Approximately 1.1 million of them live in the United States. HIV infection most often causes AIDS, which is almost always fatal.

  In 1996, with the advent of HIV antiretroviral drugs, this field completely changed. These drugs can prevent HIV from replicating and restore the normal immune system of an infected person. Because these drugs are very effective, the life expectancy of people living with HIV today is the same as that of people who are not infected with HIV.

  However, these drugs need to be taken every day, have various painful side effects, and cost thousands of dollars a month. Even with this life-prolonging treatment, it is still difficult to achieve functional HIV treatment. The definition of functional HIV treatment is that HIV patients do not respond to HIV and no longer need to take these drugs.

  "treatment" treatment

  At the 2008 Conference on Retroviruses and Optimistic Infectious Diseases, a Berlin patient named Timothy Ray Brown seemed to have healed after the press release, and everything seemed to be changing. completed. In order to achieve this unexpected "cure", Brown actively treats acute myeloid leukemia, including two hematopoietic stem cell transplants (one patient's bone marrow is damaged) and whole body irradiation. definitely is. have to. This complex treatment involves destroying a person’s immune system with high-dose chemotherapy or radiation, and then receiving a new stem cell transplant from oneself or a donor. This is a difficult remedy and increases the risk of infection and other complications (such as implant host disease, blood clots, and liver disease).

  Researchers learned that both Brown and "London patients" are adopting new treatments. For Brown and current London patients, all new blood cells transplanted into them are from donors and have two copies of the CCR5 receptor gene mutation. This mutation of the CCR5 receptor (approximately 1% of European ancestry) prevents the HIV virus from invading immune cells. This makes it resistant to most HIV infections. However, survival after transplantation cannot cure or alleviate AIDS. After receiving treatment, two patients finally terminated antiretroviral therapy. Subsequent tests showed that even with a very sensitive blood test, the team could not detect HIV in the blood. The lack of CCR5 receptors and the inability to find HIV in the blood alleviated the HIV symptoms of London patients earlier this week.

  What does this new case show? In view of the disappointment of recent hematopoietic stem cell transplantation in HIV patients, the research team reporting the patient's remission in London did not say that the patient was cured. Therefore, others should not explain this way. The remission of another HIV patient who received less toxic cancer treatment is undoubtedly encouraging, but a remission of 18 months does not mean a cure. In addition, cancer treatment in London is relatively low, only chemotherapy and stem cell transplantation are accepted, but it is still toxic and not a treatment strategy for healthy HIV-infected people. Most importantly, it is not uncommon for the AIDS community to need to understand Brown. This provides us with another and even greater reason to look forward to a future revolution in the scientific road to the treatment of AIDS.