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Very Early HIV Treatment Leads to Another New Case of a Functional Cure

July 3, 2013

More HIV cure news comes to us in the form of a German man -- not the "Berlin patient" -- who is reportedly showing no HIV in his blood after starting treatment early and then discontinuing for nine years, according to a poster presented at IAS 2013.

In the poster, German researchers report a unique case study of a 67-year-old man who was diagnosed with HIV in 1999. Tests at the time suggested that he had just seroconverted in the last month. His viral load was over 100,000 and his CD4+ cell count was below 500.

He was immediately started on a treatment regimen of zidovudine/lamivudine (Combivir) and efavirenz (Sustiva, Stocrin) and achieved an undetectable viral load shortly after. His CD4+ cell count rebounded to around 1,000.

After five and a half years of antiretroviral therapy, the patient decided to try a treatment interruption, with guidance from Jan van Lunzen, M.D., his treating physician and the study's lead author. Immediately afterward, he experienced a slight increase in viral load, but it quickly dropped back to undetectable within three months of stopping treatment.

The researchers continued to follow him for nine years and were unable to detect any HIV in his peripheral blood mononuclear cells using ultrasensitive viral load tests that detect viral loads as low as 1. Throughout, his CD4+ cell count has remained stable between 800 and 1,000.

The patient showed immune responses and lab numbers similar to those seen in elite controllers. To make sure he was not an elite controller himself, the researchers tested for a telltale mutation of the CCR5 receptor on his CD4+ cells and found none.

However, using a humanized mouse model, whereby the investigators transplanted purified donor CD4+ T cells and anti-CD3/CD28 stimulation, they were able to recover some HIV, indicating the presence of replication-competent virus and suggesting that it remains too early to consider the patient entirely cured of his HIV infection.

"The data obtained in this unique case suggest a functional cure of this patient rather than viral eradication after early onset cART (combination antiretroviral therapy)," the study authors wrote.

"The presence of strong HIV-specific T-cell responses, normal frequency of regulatory T cells and animal data suggest a strong role of preserved adaptive immune responses as a correlate of viral control in this patient. Subsequent virological and immunological studies should look into the correlate of viral control in this and other PTC patients," they concluded.

"I think all patients with early PHI (primary HIV infection) should be offered treatment. This will increase the likelihood to become a post-treatment controller," van Lunzen told

Warren Tong is the research editor for and

Follow Warren on Twitter: @WarrenAtTheBody.

Copyright © 2013 Remedy Health Media, LLC. All rights reserved.


Reader Comments:

Comment by: cheryl jones williams (albany ga.) Wed., Jan. 29, 2014 at 9:10 am UTC
They need to find a cure for aids I lost a uncle due to aids and a father n law please find a cure before we lost a nother person in this world somewhere they will be joyfully for it thanks and god bless
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Comment by: MIke (Baltimore) Tue., Jul. 30, 2013 at 9:37 am UTC
The era of death, dying, sickness and real sadness is long over. The meds changed that. Life is good.
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Comment by: Curt (london ontario canada) Thu., Jul. 25, 2013 at 9:15 am UTC
Its been almost 15 years since my diagnosis. I changed to Atripla about 3 years ago and it really has improved my overall well being. My CD4 bounces around. I visit my doc every 6 months and it has been as high as 850 when I was working out and eating healthy and being really active. It hovers in the 500's these days as my state of mind is not as healthy after loosing my partner of 11 years. Not because he died but because, at the age of 46 and living with HIV for over 25 yes, he decides that drugs were the answer. A cure can't come soon enough. I watched 'House of Boys' last night and it reminded me how fortunate we are to have the medications we have. But at the same time, with all the stigma and isolation that government and society puts on us, I wish it would all end sooner rather than later. Its so much easier when you have loving caring individuals in your life that understand your daily struggles. But its a whole different story when your alone. A cure can't come soon enough.
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Comment by: John (Panama, Florida) Mon., Jul. 15, 2013 at 6:54 pm UTC
After 3o years of death, dying, sickness and real sadness. Here is some real hope and we hope that the will not only inform everyone about each and everyone that they know about but also to celebrate with these people and future cures just like them. We must keep the momentum going and not stop not for just us but for everyone that never was or will be able see this day, sadly but fought for it just the same or harder! I speak for every sane person on this website and; hopefully, world. We want to know more about cures, hope and what our own bodies can contribute to the study against this terrible disease. Here is to the future!
Thank you!
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Comment by: dustin (ok) Sun., Jul. 7, 2013 at 1:09 am UTC
To all those like me that read these things, one day there will be news of a cure. In the mean time use this disease as a motivator not a disabled. Since my diagnosis I have been striving to meet my full potential in life because I now realize how important it is and in homage to those without the treatment options avaialable today. I love you all and you are not alone!
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Comment by: michael (los angeles) Thu., Jul. 4, 2013 at 5:31 pm UTC
so basically, there is a chance that if given a chance and enough time, the immune system can be "taught" to be an elite controller?

this is intriguing since my CD4's lately has jumped to levels not seen before, not even when i was healthy. so it might be possible that our immune system can adapt if given the chance while under HAART treatments....interestingly enough, my CD4's started to rise to uncharted levels right around 4 years after taking atripla. i started taking atripla (sustiva/truvada) a few months after seroconversion. i had the symptoms of acute hiv when i went to the doctor, first western blot was indeterminate and the second follow up western blot confirmed seroconversion. because of insurance, i wasn't given treatment until a few months after the confirmed seroconversion. before that, i usually test for hiv at least once a year.

i'm due for a check up in a few weeks. my last cd4's have been mid 600's and near 30% even though the first few years, it had hovered around 400's and 26%. nearly all cd4 panel levels have also reached normal levels, such as the cd8's and the ratio.

would be interesting of there are further studies on this and if a patient is on HAART long enough, will the remaining virus wear itself out and die.
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Replies to this comment:
Comment by: Pedro (Germany) Fri., Apr. 24, 2015 at 12:25 am UTC
This is indeed an interesting story, however I would still be cautious, it is also my case after about 4 years of treatment that my CD4 have increased to levels never seen before, i started tratment with CD4 of 230, and after 6 months i achieved in the 300-500 range for about 3 years, however last checkup showed 760! I dont think it is a lab failure, but a consequence of a long-standing battle against the virus, and of not having a very demanding job at the moment, stress really kills your CD4!
Anyhow, if the immune system can really be "taught" to be an ellite controller will depend on how late did you start taking meds, and how deep has the viral reservoir spread before treatment was effective.

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Please note: Knowledge about HIV changes rapidly. Note the date of this summary's publication, and before treating patients or employing any therapies described in these materials, verify all information independently. If you are a patient, please consult a doctor or other medical professional before acting on any of the information presented in this summary. For a complete listing of our most recent conference coverage, click here.


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