Transplants, or the very early treatment of the disease, are some of the clues explored by specialists so that AIDS patients are not forced to take medication until the end of their lives.
The results are still preliminary, with only a small number of cases, but they already give hope.
A few weeks ago, a group of American scientists announced that a woman with leukemia in New York managed to be cured of AIDS after receiving stem cells extracted from an umbilical cord. Before her, three patients, in Berlin, London and Dusseldorf, had already been cured, after undergoing a bone marrow transplant, initially intended to fight the cancer they suffered.
This transplant from a matched donor, whose cells were resistant to HIV, made it possible to replace the infected patient’s blood cells and rebuild his immune system. These cases involve, however, quite complicated operations, impossible to be reproduced in a generalized way.
Since the acquired immunodeficiency virus (HIV) was isolated by Drs Françoise Barré-Fitoussi and Luc Montagnier in 1983, science has made great strides. The first tritherapies (combinations of three drugs) made it possible, from 1996 onwards, to save countless patients and, for the sick, this meant leading a reasonably safe life.
Therapies with drawbacks
Tritherapies are not harmless, however. Those taking these drugs have a higher risk of developing other diseases (such as cardiovascular disease and cancer) and sometimes compatibility issues arise. Furthermore, in many countries, access to these tritherapies is not guaranteed, recalled Michaela Müller-Trutwin, a professor at the Pasteur Institute in Paris, at a recent symposium.
“Currently, patients tell us they want a treatment they can stop,” Françoise Barré-Sinoussi told AFP. “Must try,” she added.
Some patients who received very early antiretroviral treatment were able to “control the infection naturally” after stopping their tritherapy, he reported.
A very small part of these patients, infected with AIDS for a long time, manage to get off tritherapy, thanks to their genetic peculiarities that allow them to strengthen the immune system.
“Based on these cases, we can better understand the mechanisms that must be taken into account in a therapeutic strategy. We increasingly have more data that show, for example, the important role played by NK cells [do inglês natural killers, ou assassinas naturais] contained in the lymphocytes of the immune system, capable of killing the infected cells”, stated Barré-Sinoussi.
Other new possibilities are gene therapy, or immunotherapy, to modify the cells, or the receptors of the virus, he added, stressing, however, that care must be taken about the possibility of totally eliminating the infection from patients.
“This would mean that there are no infected cells left in the body, which seems unlikely,” noted Jennifer Gordwood, a postdoctoral student at the Karolinska Institute in Stockholm, Sweden.
The problem with HIV is that it installs itself latently in cells “and can be reactivated, for example, when treatment is interrupted,” he explained.
“In the beginning, we thought it would be necessary to eradicate the virus by 100% and, now, we are beginning to understand that it is enough to introduce barriers” to control it, strengthening the cells, or stimulating the immune system, highlighted Michaela Müller-Trutwin, an objective that it may take decades to achieve.
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