Scientists reveal a functional cure for AIDS

U.S. scientists have discovered two people infected with HIV whose immune cells behave differently from those of other infected people and can still control viral load years after infection. In addition, the two patients were infected with cells carrying a large number of viruses, but blood tests showed no viral load. Although based on a small number of patients, the results suggest that long-term viral remission is possible for more people, the researchers said.
results were published online online in JCI Insights.
Joel N. Blankson, a professor at Johns Hopkins University School of Medicine, said: "One of our patients was infected with HIV almost 20 years ago and discontinued treatment after several years of antiretroviral therapy (ART), which has been 'virus-free' for 15 years since art was discontinued. And our results suggest that early use of ART can reset a patient's immune system, and even if the treatment is stopped later, the virus can still be controlled. In addition, he added, "Understanding how this happens can help HIV-infected people achieve a 'functional cure'." The
HIV infects the immune system's CD4-plus T cells and uses them to replicate the virus to produce more viruses. In the early stages of infection, another type of immune cell (CD8 plus T cells) can identify and kill HIV-infected CD4 plus T cells. However, under normal circumstances, the virus replicates very quickly, and eventually cd8-plus T cells will not be able to keep up with the virus replication, and they will apoptosis themselves.
the new study, researchers focused on two people living with HIV who were not tested for HIV levels in routine tests. One of them, known as elite virus suppressors, carried special genetic markers on his immune cells that allowed his body to naturally maintain low viral levels without treatment, and the other patient, a so-called treatment-obtained virus controller, received ART for several years and stopped the treatment 15 years ago without carrying any protective genetic markers.
as part of patients' regular visits over the years, their blood is collected to detect viral loads. The researchers isolated CD4 plus T cells from their blood samples. Although they did not have measurable levels of viral load in their blood (an unusual feature of HIV-infected people who can control the virus), both patients had large numbers of HIV-infected CD4-plus T cells in their bodies.
previously, the presence of large virus libraries in CD4-plus T cells was considered a major obstacle to HIV eradication because it contained a large number of viruses that could replicate and spread quickly. However, this does not appear to have happened in these patients, and the researchers then conducted further studies to determine the cause.
samples collected from patients over the years, the researchers isolated the virus from samples from virus controllers and sequenced the virus's genetic material. They found that the virus in the 2010 sample was identical to the other two samples taken six months apart in 2017. The results are surprising because, usually when HIV replicates, the virus continues to mutate, and as a natural evolutionary process, the most adaptable version of the virus continues to multiply.
the same facts as these viruses suggest that replication is done through a process called clone amplification," said Blankson, a professor at the U.S. Department of Human Security. This is the division of infected resting cells in the virus reservoir, resulting in the precise replication of all viral genes. After
determined that the viruses were the same, the researchers then examined whether CD8-plus T cells controlled the virus to some extent. The team isolated CD8-plus T cells from each patient and mixed them with virally infected CD4-T cells from the same patient; The researchers eventually found that the virus controller's CD8 plus T cells were able to suppress the virus in the body, while the non-viral controller's CD8 plus T cells were unable to suppress their own virus. This suggests that although virus controllers also have a large number of infected CD4-T cells, they are still able to maintain below-detected viral loads for long periods of time, and the behavior of CD8-T cells is key.
. Rebecca T. Veenhuis, of the university's school of medicine, said, "We believe this is the first time that HIV-specific CD8-T cell reactions have been found in therapeutic access virus controllers. The results suggest that functional cures are still possible, despite the huge library of viruses. (Source: Zhao Xixi, China Science Daily)