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A small percentage of HIV patients may naturally reach a “functional cure,” isolating the virus into parts of the human genome so remote, it is unable to replicate, according to new research.
The only other known cure offering long-term HIV remission resulted from bone marrow transplants in two people. However, these transplants are risky, expensive and not a realistic option for the estimated 38 million people with HIV infections worldwide.
Last month, news surfaced of a Brazilian man who might have cleared an HIV infection through a combination of antiretroviral drugs and nicotinamide to rout out the virus lingering in the HIV reservoir in the human genome. However, researchers have raised skepticism over those preliminary findings, saying it is too soon to tell.
In the current study, published on Wednesday in Nature, researchers from the Ragon Institute of MGH, MIT and Harvard, among other institutions, discussed how they used "next-generation sequencing" to show how less than 0.5% of HIV infected people can naturally control the virus' replication, without the use of any drugs or risky surgery.
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This very small percentage of patients, called "elite controllers,” can stifle the virus to, what researchers coin, the “gene desert.” Due to elite controllers' powerful immune systems, the virus "hides" in remote spots in the genome, far away from machinery that human genes use to produce proteins, Dr. Xu Yu, study senior author and researcher at the Ragon Institute, explained to Fox News.
Yu said the HIV virus is "very smart to use human machinery to reproduce themselves."
Other HIV patients may take antiretroviral therapy (ART) drugs, sometimes for more than 20 years, but Yu said that the new, advanced sequencing technology can be used to analyze these patients' viral profiles to see when they reach a state similar to that seen in elite controllers, so they can stop treatment and live healthy lives.
Researchers analyzed 1.5 billion blood cells from one HIV patient, 66-year-old Loreen Willenberg of California, which detected the virus, albeit it was defected and not intact, or unable to give rise to new virus, Yu said.
However, millions of cells from the woman's digestive system did not detect any virus. Despite the comprehensive analysis using several complementary technologies, Yu says the team can "never reach the truth" and say the patient is “absolutely cured” of HIV unless every cell in her body is analyzed to detect for the virus.
Another 63 patients in the study reportedly controlled their HIV infections without medications either, also potentially reaching a "functional cure", per the New York Times.
“What we are hoping now to learn from these studies how do we enhance the immune responses from other patients so they can reach the same status [as elite controllers],” Yu said. “We do not need to eliminate every single virus from the human genome in order to achieve a functional cure to HIV.”
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