A man in Brazil is believed to be the first person in the world to be completely cleared of HIV after a purely pharmaceutical intervention. The patient in Sao Paolo, aptly named 'The Sao Paolo Patient', was treated with a huge amount of anti-viral drugs, so called antiretroviral therapy, over the course of 48 weeks. After the 48 weeks he emerged as HIV free.
The patient, believed to be in his mid-30s, was first diagnosed with HIV in 2012. He was not only treated with a cocktail of antiviral drugs but also nicotinamide, which is an enhanced form of the vitamin B3.
Dr. Ricardo Diaz of the University of Sao Paulo who helped lead the study said of the remarkable breakthrough:
"We can't search the entire body, but by the best evidence, we do not have infected cells. I think it's very promising. This patient might be cured."
Dr. Jonathan Stoye, head of the Retrovirus-Host Interactions Laboratory at the Francis Crick Institute, added:
"This report describes a man from Brazil who seemingly is free of HIV-1 following treatment with multiple antiretroviral drugs (ARVs) in combination with Vitamin B3. If true, this would be the first solely drug-induced AIDS cure."
But he also stated his reservations:
"Altogether, this is a remarkable claim, but exceedingly frustrating given the lack of detail about the virological status of the "Sao Paulo Patient" or a plausible model for effect of vitamin B3. I am not convinced."
Indeed, it is believed that out of 5 patients treated in this way, only the Sao Paolo patient appeared to be rid of his HIV infection.
Andrea Savarino, a doctor at Italy's Institute of Health, who was also involved in the treatment program stated the he believed that it was perhaps too early to get overexcited about the prospect of this being a cure for all. He said:
"I really hope that it may boost further research into an HIV cure. The result is highly likely not to be reproducible. This a very first (preliminary) experiment, and I wouldn't foresee beyond that."
A man appears to have been cured of HIV with a relatively cheap, non-toxic combination of drugs. Dr Andrea Savarino, one of the study researchers, talks to aidsmap's Gus Cairns & Liz Highleyman.
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However, this does mean that lessons learned through this treatment may be a springboard to a treatment that works for far more patients.
This isn't the first time that a patient has been cleared of HIV. Adam Castillejo, a Venezuelan man treated in London, underwent a bone-marrow transplant to cure his blood-cancer in 2016. The bone marrow was stripped from an individual with HIV resistant genes (a feature some individuals naturally have) and the transplant ended up not only curing his cancer but also his HIV. These procedures are however highly risky as bone marrow transplants often result in death, even in patients who do not have HIV.
HIV which often develops into AIDS, has killed tens-of-millions of people since it was first discovered in the 1980s and is still a major killer in poorer countries. Thankfully in the West where antiviral treatments are now available the disease can be held firmly in check. In the UK, HIV is no longer regarded as a life-limiting illness, meaning those with HIV are expected to live almost as long as those without HIV. HIV patients are even expected to live longer than people diagnosed with more common conditions, such as type 2 diabetes.
Let us hope though, that this study brings us closer to the day when we can clear people of HIV altogether.
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