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In search of healing: the infection by HIV remission and long-term post-treatment control suggests possibility of functional healing

Mujer en el mar front of la luna llenaA young woman who was infected with HIV at birth of his daughter and received antiretroviral therapy (ART) too early and a baby have maintained a viral load below the standard test detectability limit for more than twelve years after the suspension of treatment, shedding more light on the "post-treatment control" as a potential functional cure strategy.

In 2014, researchers reported disappointing news in the search for a cure for HIV. THE"Mississippi Baby"- A child who has led many experts to believe that the girl could have been HIV - has yet been found carrying the virus and a pair ofpatients undergoing bone marrow transplantationBoston; there was viral rebound several months following discontinuation of experimental treatment. This leaves Timoth Brown,The Berlin patientAs the only one which still seems to have been cured of HIV.

During the International AIDS Society Conference in July, Asier Saez-Cirion the Institut Pasteur de ParisHe described the case of a young womanWho was born to an HIV positive mother with a high viral load, who were given preventive maintenance with zidovudine (AZT) immediately after delivery, but nevertheless became HIV positive. She started combination ART 3 months after birth, but about 6 years later she was taken care coma ART. When she returned to the Clinical Center a year later she had an undetectable viral load and we kept it untreated. Now, off of ART for more than twelve years, women have undetectable plasma viral load according to standardized tests and their CD4 count remains high and stable, but the researchers were able to detect the DNA replication of HIV in their cells.

Saez-Cirion said this is the first known case of remission very long term HIVin an infected person around the birth and treated early - about ten years longer than the baby of Mississippi.

Indeed, post-treatment such controls appear very rare form. Saez-Cirion has followed a group of French adults in a study known as the cohortVISCONTIwho started treatment in acute or early HIV infection, interrupting him then and who has maintained plasma viral load undetectable therapy. But they are not free of HIV DNA in their T cells and other body parts.

APaper presented at ID WeekIn October found that only 4 individuals in a group of almost 5 thousand people receiving care at US military health showed immune control of HIV after starting ART, achieving viral suppression and treatment discontinuation.

Unlike "elite controllers"Which have a strong immune response to HIV and viral load remains low without treatment, the French study and some patients in the cohort VISCONTI seem to have an unusually weak response to the virus. This can be advantageous, as its T-cell rest not be activated and they can avoid persistent inflammation typically seen in people with HIV untreated. This suggests that quell the immune response to HIV - rather than reinforcing it - may be a practical approach to achieve a cure.

Posted on Thursday, 30 2015 00 December: 00

Written by Liz Highleyman

Asier Saez-Cirion in 2015 IAS for an HIV cure meeting

Translated by Claudio Souza's originalLong-term HIV Remission and Post-Treatment Controlin AIDSMAP.COM

Reviewed by Mara Macedo in 3 2016 January

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