Proof of Concept?: Fourteen people with HIV achieve a "functional cure" in France.
March 18, 2013
14 French People With HIV Have Achieved ‘Functional Cure’
Following on the heels of groundbreaking news that an American baby has apparently achieved a “functional cure” of HIV comes the announcement that 14 French adults treated within two months of infection also maintain undetectable virus levels after stopping antiretroviral (ARV) therapy, MedPage Today reports. Unlike in the elusive “sterilizing cure,” in which the body would be cleared of all HIV, in a functional cure, the body can control HIV without the help of meds. As such, there is still virus in all members of the French group, although it is only detectable with highly sensitive tests. Drawing from the VISCONTI study, French researchers published their findings in the online edition of PLOS Pathogens.
All 10 men and four women who achieved the functional cure were treated during primary (also known as “acute”) infection and then remained on ARVs for between 1 and 7.6 years; the median length was 36.5 months. The individuals terminated treatment for various reasons, including the wish to take a break from ARVs and their participation in a study about treatment interruption.
The group has remained off ARVs for between 4 and 9.6 years. Eleven of them maintain viral loads below 40, and three of them below five copies. Standard viral load tests reach an undetectable reading below a level of 50, yet more sensitive single-copy assays can detect lower levels.
These 14 people were a part of a larger study group of 756 in the French database who started ARVs within six months of infection between 1997 and 2011 and stayed on therapy for at least a year. Among those in this group who began with a detectable viral load and reached undetectable levels, 70 latter stopped their regimens and had subsequent viral load tests conducted. Fifty-six people who made up the balance of that group of 70 did not experience viral control like the group of 14 who achieved this functional cure. The scientists estimated that 85 percent of people treated this early would experience early viral rebound if they went of their medications.
While these findings won’t lead to immediate practical implications for HIV treatment, the researchers argue they are a proof of concept that there are circumstances in which the immune system can control the virus.
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