What happened after the two HIV-infected patients stopped treatment?

Since the first AIDS case was reported in 1981, HIV (HIV) has been one of the deadliest and most persistent epidemics in mankind
.

Although the HIV epidemic continues, extraordinary progress has been made in new AIDS cases and related deaths worldwide
.

According to UNAIDS data, 40 years after the first AIDS case, the number of people receiving HIV treatment globally has more than tripled since 2010
.

It is estimated that since 2001, high-quality and affordable treatment has prevented 16.
2 million deaths
.

As we all know, HIV is a retrovirus that can attack the human immune system.
It attacks and destroys the most important CD4+ T lymphocytes in the human immune system in large quantities, causing patients to develop AIDS after several years or even more than 10 years of incubation period.
The patient eventually loses immune function
.

Today, the decline in the incidence, prevalence, and related deaths of AIDS is due to the advent of antiretroviral therapy (ART)
.

Since 2010, the number of AIDS-related deaths has fallen by 43%, and by 2020 it has fallen to 690,000
.

Although great efforts have been made and the current results have been achieved, more and more evidence shows that it is impossible to completely eliminate the HIV virus with existing antiretroviral drugs, plus the potential side effects and drug resistance of lifelong medication With the development of sex, scientists have turned to the development of another immune-based therapy with the goal of suppressing the virus to the maximum in the absence of antiretroviral drugs
.

Recently, in a new study published in Nature Medicine, a research team led by Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAID) and others, discovered two different mechanisms.
It can allow HIV-infected people to stop antiretroviral drugs under medical supervision and extend the time to control HIV, thereby helping them to relieve their condition without taking drugs for life
.

These findings provide important information for the development of new anti-AIDS therapies
.

In this study, the researchers conducted a long-term follow-up study on two patients participating in an HIV clinical trial
.

The two participants started receiving antiviral treatment during the acute phase of HIV infection
.

Before discontinuing treatment, they received clinically effective antiretroviral drugs for 6.
7 years and 6.
5 years, respectively
.

The researchers followed them up for 4 years and 5.
6 years respectively, at intervals of approximately every two to three weeks
.

Throughout the follow-up period, both participants maintained a relatively stable CD4+ T cell count
.

The researchers monitored the time and extent of viral rebound in each participant, that is, when the HIV viral load in their blood became detectable
.

One of the participants suppressed HIV by intermittent rebound for 1250 days (nearly 3.
5 years), after which he started taking suboptimal antiretroviral drugs without telling the research team
.

Another participant almost completely suppressed HIV for 1434 days (nearly 4 years), but then the virus rebounded sharply because he was infected with another HIV strain
.

This phenomenon is called "superinfection"
.

The researchers found that there are high levels of HIV-specific immune cells CD8+ T cells in the first participant, which can kill HIV-infected cells; the second participant has a weaker response to HIV CD8+ T cells.
But during the follow-up period before the virus rebounded suddenly, the neutralizing antibody response was very strong
.

These conditions indicate that two different HIV control mechanisms are working in the two participants, and the neutralizing antibody may achieve almost complete inhibition of HIV until the patient is infected with a different HIV strain again
.

Researchers say that a deep understanding of the mechanisms by which certain HIV-infected individuals spontaneously control viral replication will help develop new treatment strategies to achieve sustained viral suppression without the need for antiretroviral therapy
.

The team finally emphasized that in order to avoid the emergence of HIV drug resistance and prevent misunderstanding of scientific data, it is very important to conduct routine antiretroviral drug testing for HIV-infected people who have stopped treatment for a long time
.

In addition, "superinfection" is a potential cause of breakthrough infections in HIV-infected individuals who have stopped treatment, especially after prolonged virus suppression
.

Link to the paper: https:// Related reading: Amazing discovery! More than 4% of HIV patients in the Democratic Republic of the Congo can naturally suppress the virus without taking medicine.
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