A woman who was diagnosed with HIV almost 30 years ago may have been cured of the virus – without taking medication or having a bone marrow transplant.
Scientists have been studying Loreen Willenberg for decades, with the 66-year-old insisting she never took medication to keep the virus at bay. Doctors say that her body fights the infection naturally.
But now academics claim they can ‘be added to the list’ of cured HIV patients, alongside ‘Berlin patient’ Timothy Ray Brown and ‘London patient’ Adam Castillejo.
Both Mr Brown, 54, and Mr Castillejo, 40, had cancer and received a bone marrow transplant from a donor with HIV-resistant genes to fight off their disease and the AIDS-causing virus in one fell swoop.
Ms. Willenberg – who was diagnosed in 1992 and is considered an ‘elite controller’ who has the rare ability to suppress the virus on her own – has never had the risky treatment.
Researchers from the Ragon Institute of MGH, MIT and Harvard found no traces of HIV in California women through standardized tests.
Advanced technology that analyzed 1.5 billion of Ms. Willenberg’s blood cells found small amounts of the virus, meaning she is not HIV-free. But the doctors found that their immune system was unable to reproduce the remaining spores.
Scientists have been studying Loreen Willenberg for decades, with the 66-year-old insisting she never took medication to keep the virus at bay. Doctors say that her body fights the infection naturally
Dr Sharon Lewin, director of The Peter Doherty Institute for Infection and Immunity in Australia, told the New York Times: ‘She could be added to the list of what I think is a drug, via a very different path. ‘
Another 63 patients who were not on antiretroviral drugs also found traces of HIV that could not reproduce.
The team, whose work was published in the journal Nature, says the findings provide evidence that these people have achieved a ‘functional cure’.
Elite controllers are believed to account for only 0.5 percent of the 37 million people living with HIV worldwide.
Researchers found that because of where these patients encoded the virus in their DNA, the pathogen could not make copies of itself. This one keeps the virus below detectable levels, making it non-communicable.
Once a person contracts HIV, the virus starts attacking and destroying immune cells that normally protect the body against infection.
In recent decades, physicians have gained a much improved understanding of how to control HIV. The death toll from the disease has dropped since the peak of the AIDS epidemic in the early 1980s.
It is treatable and doctors recommend taking a combination as a ‘cocktail’ of medicines known as antiretroviral therapy, such as ART.
Adam Castillejo, 40, was the second person in the world to be cured of HIV. Earlier this year, he revealed that he was the ‘London patient’
‘Berlin patient’ Timothy Ray Brown was successfully cured of the HIV virus 12 years ago
Within six months of taking the medication once a day, a person’s viral load will be virtually undetected, but the body will not completely release it.
This is because the virus hides in the body by integrating the genetic material into DNA and forming what is known as a latent reservoir.
But ART – which can cause nausea, diarrhea, headaches and fatigue – is not able to destroy these reservoirs, but if an HIV patient stops taking the ‘cocktail’, the virus can start making it again of copies.
Elite controllers have latent reservoirs, but they do not need to take medication to stop the virus from spreading through the body.
‘They naturally maintain what other people need ART to do,’ co-author Dr Mathias Lichterfeld, a communicable disease doctor at Ragon, told HealthDay.
For the study, the team looked at blood samples from 64 elite controllers and 41 HIV patients who took ART.
Results showed that, in elite controllers, HIV genetic material was found in so-called ‘gene deserts’ of the DNA. This is where there is not much gene activity, so the virus cannot make copies of itself and instead remains in a ‘blocked and locked’ state.
Lead author Dr Xu Yu, a professor of medicine at Harvard Medical School, said: ‘This position of viral genomes in elite controllers is very atypical.
‘In the vast majority of people living with HIV-1, HIV lies in the active human genes where viruses can be easily produced.’
Dr. Yu calls this a ‘functional drug’, which occurs when a virus is still present in the body but can be controlled without medication.
The researchers believe this is because, in the early days of infection, the immune system of elite controllers killed the virus after integrating it into DNA regions with a lot of gene activity.
The team says the findings could lead to a cure, by making drugs that replicate the phenomenon of elite controllers, or that eliminate HIV that is integrated into parts of the DNA that have substantial gene activity.
Elite controllers carry a mutation of CCR5, which prevents it from expressing it, which essentially completely blocks the gene. Experts say the genetic peculiarity stems from Northern Europeans.
The study comes after a Brazilian man in his mid-30s with HIV went into long-term remission after treatment with medication and vitamin B3.
Doctors last month unveiled the case of the ‘Sao Paolo patient’, who is understood to be the first HIV patient in the world to go into remission after pharmaceutical treatment.
And scientists revealed last year that a third HIV-positive patient in Germany could be free of the virus after undergoing the risky bone marrow transplant.
But neither the ‘Sao Paolo patient’ nor the ‘Düsseldorf patient’ were free enough from the virus to be considered cured.
For example, cancer patients must be in remission for five years before they are designated as cured.
Unfortunately, the cases of Berlin and London patients do not change the reality much for the millions of people living with HIV.
The treatment probably has no potential on a broader scale, because both Mr Castillejo and Mr Ray Brown were given stem cells to treat cancer, not HIV.
Stem cell and bone marrow transplants are life-threatening operations with enormous risks. Dangers lie in the patient suffering a fatal reaction if replacement immune cells are not taken.
Mr. Ray Brown, who is from Seattle but was treated in Germany, has been HIV-free without medication for 12 years.
But Mr Castillejo, whose mental health has drastically deteriorated over the years and led himself to end his life, was only treated in 2016.
HIV patients known as ‘elite controllers’ have integrated the virus into parts of their DNA where there is not much gene activity, which prevents the virus from making copies of itself (file image)
HIV can be treated and doctors recommend taking a combination as a ‘cocktail’ of medicines known as antiretroviral therapy, such as ART (stock)
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