New Case of Post-Treatment Control

Researchers in the Netherlands have shared study results detailing a new case of post-treatment control of HIV.

Most people living with HIV who stop antiretroviral therapy (ART) are unable to control the reactivation and replication of the virus, but a few cases have been noted where people can control HIV either without ART (called elite controllers) or after ART had been initiated and then halted. Published in the journal AIDS, the new findings try to explain how a man has been controlling the virus for 23 years, following a short course of treatment.

Dr. Jori Symons of University Medical
Dr. Jori Symons of University Medical Center Utrecht, the Netherlands

Diagnosed in 1998 when he was 49, the man started ART, suppressed his viral load to undetectable levels seven months later, and eventually discontinued all regimens. He remained engaged in care and was checked by physicians on a regular basis. Except for one small spike of his viral load seven months after he stopped ART, he has remained undetectable (below 200 copies) for close to two decades post-treatment. The virus is still present and intact in his cells and blood.

Comprehensive genetic and immunological analyses by researchers, including past amfAR grantee Dr. Jori Symons of University Medical Center Utrecht, the Netherlands, suggest why the man has been able to achieve post-treatment control—strong CD8 responses and a virus that seems slow to replicate possibly due to a mutation.

Commenting on the case, Dr. Jeffrey Laurence, amfAR’s senior scientific consultant, said: “This case is important because it gives us new insight into the different ways it may be possible to achieve post-treatment control.”

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