New Evidence Suggests That Early, Aggressive HIV Treatment May ‘Functionally Cure’ The Virus

Earlier this month, scientists reported that they may have “functionally cured” a two-and-a-half year old child of her HIV infection by treating her with aggressive rounds of drugs as soon as she was born. They weren’t sure what that meant for adults living with HIV, since doctors may have simply prevented the transmission of the virus rather than eliminating an existing infection. But a new study suggests the same method may also work for individuals who contract HIV infections later in life.

French researchers are reporting that 14 adults have been “functionally cured” of their infections after undergoing initial treatment for HIV. The adults — just as the baby girl who was the subject of the earlier study — were aggressively treated with HIV drugs during the first two months of their infections. Now their infections are under control, and the ten men and four women in the group haven’t needed to take any HIV drugs for between four and 10 years. HIV-positive individuals are typically unable to stop undergoing HIV treatment without experiencing a “sharp and dangerous” increases in HIV replication.

Asier Sáez-Cirión, who helped analyze the findings at the Institut Pasteur in Paris, told MedPage Today that the study’s results suggest that early treatment may have some hope of “curing” HIV infections:

Although the phenomenon may not have immediate clinical implications, he said, it’s “proof of concept” that the immune system can control HIV in some circumstances.

It may also offer hope for a vaccine, he said. “It shows there is some immune response,” he said, “that can be stimulated not just to control infection but to prevent infection if that part of the immune system can be primed and activated.”

Indeed, the researchers argued that study of these patients and others like them could “open up new therapeutic perspectives” for people with HIV.

To be clear, scientists don’t know if these cases of “functional cures” will have broader implications for the 34 million people living with HIV around the world. As Sáez-Cirión points out, additional scientific research is needed to assess whether the phenomenon can be replicated on a wider scale. But it may help direct public health advocates’ energy toward effective methods of combating the virus in the very early stages of infection, and it also highlights the importance of regular testing so that newly infected individuals can become aware of their HIV status before going too long without treatment.

Here in the U.S., the CDC is focusing its efforts on expanding access to affordable HIV testing, particularly in the low-income urban areas where the virus tends to be most highly concentrated — but there’s still more work to be done, considering that about a quarter of the HIV-positive Americans aren’t aware they have the virus. Fortunately, HIV testing will be covered under Obamacare.