May 22, 2013
Once you're diagnosed with HIV, you're HIV positive for life.
For about as long as we've been aware that HIV exists, that has been the reality. But in just the last few months, we've seen new signs that it may be possible -- really, truly possible -- to defang HIV in a person who's living with the virus.
There's a big "but," however: For this to work, the person may need to be diagnosed -- and then start taking HIV meds -- very quickly after she or he was first infected. That little wrinkle appears to be the secret to the functionally cured baby who made worldwide headlines in March. It's also the key detail in a recently published study in which 14 people who began HIV treatment shortly after their infection were able to eventually stop their meds -- and yet still maintain extremely low viral loads.
That 14-person study, called the VISCONTI study, is especially exciting because the people involved don't appear to be any different, biologically speaking, from any other adult who's living with HIV. Unlike most people living with HIV, though, they were diagnosed very quickly -- generally within four to eight weeks of their initial infection, during the period doctors commonly call "primary" or "acute" HIV infection.
Once they were diagnosed, these people all started HIV treatment with some of the best available drugs at the time (all were diagnosed in the late 1990s or early 2000s) and remained on meds for between one and eight years, depending on the person. The drugs worked well, driving their HIV viral load down to extremely low levels and (in most cases) helping their CD4 counts rise.
Then, under the supervision of their doctors, these 14 people stopped taking HIV meds. And the virus didn't come back. It's now been between four and 10 years since they took their last HIV antiretroviral pill, and all of them still have extremely low viral loads and good CD4 counts -- almost as though the meds had helped "train" their bodies to fight off HIV on their own. It's also possible that, as other recent research suggests, starting HIV treatment early prevents the virus from settling into "reservoirs" within the body that our current meds are then unable to reach.
Now, it's important to note that the VISCONTI study only involves 14 people. We have very solid research, involving a much larger number of people, that warns us it's not a good idea to simply stop taking HIV meds, no matter how well we think we're doing. Do these 14 people have some kind of rare, genetic quirk that eventually helped their immune systems gain an upper hand on HIV after the meds provided an initial boost? Was the type of HIV they were infected with somehow less robust than other types, making this miracle more likely to happen?
We don't yet know. But for now, the VISCONTI results raise some exciting possibilities, especially for people who were fortunate enough to get diagnosed with HIV and then start HIV treatment within weeks of their infection. They suggest that, although a true cure for the virus is still a distant light on the horizon, the hope for a medication-free life with HIV may glow much more closely.
Myles Helfand is the editorial director of TheBody.com and TheBodyPRO.com.
Follow Myles on Twitter: @MylesatTheBody.
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