A miracle cure against HIV

the story So Far: There is great excitement in the medical world when scientists reported that a woman living with HIV (Human Immunodeficiency Virus) and undergoing an experimental treatment is likely to ‘recover’. So far only three people have been reported to be cured of HIV.

What do we know about treatment?

This week at a conference on retroviruses and opportunistic infections, Colorado, United States. Researchers describe the case of a 60-year-old African American woman who was diagnosed with HIV infection in 2013 who was started on a standard HIV treatment regimen of anti-retroviral treatment (ART) therapy consisting of tenofovir, emtricitabine and raltegravir . He was also later diagnosed with leukemia in 2017.

That year she received cord blood, or embryonic stem cells, from a donor with a rare mutation that naturally prevents the HIV virus from infecting cells. She was also given blood stem cells, or adult stem cells, from a relative. The adult stem cells boosted the patient’s immunity and possibly helped the cord blood cells integrate more fully with the woman’s immune system.

Three years after the transplant, the woman was off ART and today, for more than 14 months, her doctors report that there is no sign of HIV in her blood and no detectable antibodies to the virus either.

Embryonic stem cells are potentially capable of developing into any type of cell and hence their appeal as a therapy, although there is no explanation as to why this method of treatment appeared to be more effective.

What’s so special about this woman’s recovery?

Reportedly only two people have been cured of HIV so far and both have relied on bone marrow transplants from donors who carried a mutation, called CCR5 delta 32, which naturally leads to an HIV infection and AIDS. Builds an immunity to.

Timothy Ray Brown, or the ‘patient from Berlin’, stopped the virus for 12 years, but died of cancer in 2020. Another patient, Adam Castilejo, was the second reported case of treatment. Both men received bone marrow transplants from donors who carried a mutation that blocks HIV infection. However, previous transplants involved adult stem cells and these cells from the bone marrow replaced their immune system. The body’s natural tendency is to reject foreign stem cells and hence both donors suffered side effects such as graft versus host disease where the donor’s cells attack the recipient’s body. Both men developed serious illnesses during their HIV remission, but in contrast the female was discharged from the hospital within 17 days after transplant and did not develop graft versus host disease. Her doctors believe that it was a combination of embryonic and adult stem cells that led to better health outcomes. However, because it has only been five years since she became HIV-free, it remains to be seen whether the woman will live longer than Brown or Castilejo.

Is this treatment the long-awaited cure for AIDS?

Absolutely not. While this approach is certainly a welcome addition to the treatment arsenal, stem cell therapy is a cumbersome exercise and barely accessible to most of the world’s HIV patients. Furthermore, it requires stem cells from that rare group of individuals with beneficial mutations. Over the years, anti-retroviral therapy has now ensured that HIV/AIDS is not always a death sentence and that many people with access to appropriate treatment have a lifespan comparable to those without HIV.

A vaccine for HIV or a drug to eliminate the virus is still elusive and will be the long-sought ‘cure’ for HIV/AIDS.

What is the prevalence of HIV/AIDS in India?

According to the India HIV Estimation 2019 report, the estimated adult (15 to 49 years) HIV prevalence trend in India has been declining since the peak of the epidemic in the year 2000 and stabilizing in recent years. In 2019, the prevalence of HIV among adult males (15–49 years) was estimated at 0.24% and adult females at 0.20% of the population.

There were 23.48 lakh Indians living with HIV in 2019. Maharashtra had the highest number of 3.96 lakh, followed by Andhra Pradesh (3.14 lakh) and Karnataka.

India’s National AIDS Control Organization says ART is “available free of charge” to all those who need it and that there are centers across the country where they can be availed.