August 1, 2012
Toward a Cure: Virologic Control Documented in 14 Acute HIV Treaters
by Tim Horn
A new study released Thursday, July 26, at the XIX International AIDS Conference (AIDS 2012) in Washington, DC, found that 14 people living with HIV have achieved long-term non-progressing “viral controller” status after being treated with antiretrovirals (ARVs) during the acute phase of their infections. The fact that these individuals have shown no signs of viral load rebounds following termination of their prescribed treatment regimens may ultimately provide guidance to scientists pursuing “functional” HIV cures.
The 14 individuals described at AIDS 2012 by Charline Bacchus, PhD, of the French National Agency for Research on AIDS and Viral Hepatitis (ANRS) comprise the Virologic and Immunologic Studies in Controllers after Treatment Interruption (VISCONTI) cohort.
VISCONTI participants initiated ARV therapy within ten weeks of becoming infected with HIV and remained on treatment for roughly three years. They averaged 500 CD4 cells and viral loads of 100,000 copies upon starting treatment. Roughly six-and-a-half years after stopping treatment, the average CD4 cell count was 900 and all study subjects had viral loads below 50 copies.
"Six years after interruption of treatment, patients treated early on in the post-infection period present a perfect ability to control the HIV infection,” Bacchus said. She added that VISCONTI cohort participants also possess an extremely small reservoir of HIV in CD4 cells, similar to levels seen in “elite controllers” who spontaneously reduce their viral loads to undetectable levels without treatment.
Could it be that VISCONTI cohort participants would have been elite controllers without the use of ARVs? Not likely, Bacchus explained, as the patients’ human leukocyte (HLA) patterns—the genes related to immune function in humans—differ from those seen in individuals participating in untreated virologic controller cohorts.
Bacchus noted that research is ongoing to explore the immunologic characteristics that allowed these patients to remain off treatment, without viral load rebounds.
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