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I wonder if there people who were cured of HIV only by means of highly active anti retro-viral therapy (HAART) or other drugs rather than by bone marrow transplant?

I know that HAART can suppress HIV below detectable level but are there people who stopped HAART and did not experience the HIV levels rising?

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2 Answers

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Since early March we know, that there is the first patient which has been cured by HAART. According to the paper it has been proven that the infant was infected with HIV. This was done by detecting the virus even after the first 48 hours, this rules out that the virus transmitted by the mother without infection.

The infant was first treated when it was 30 hours of age with a triple therapy (zidovudin, lamivudin and nevirapin). On the seventh day the therapy was changed to zidovudin, lamivudin and lopinavir/ritonavir. After one month of therapy no replicable virus particle could be found. The therapy was continued until the age of 18 months. The infant is now 26 months without a sign of a rebound of the HIV infection.

The approach was atypical, since they used a therapy scheme with not established high dosing of the antiretroviral drugs. They ruled out a innate HIV-immunity by certain HLA variants, since Mother and child had matching HLA-Haplotypes. But other genetic mutations are still possbile.

This is scientific progress, the answer to your questions changes in only 2 months.

[1] http://www.retroconference.org/2013b/Abstracts/47897.htm

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Is not it the same as post-exposure prophylactic, which is used if a surgeon or a dentist get wounded when performing operation on a HIV patient? I know that one can be cured if the treatment is started within 48 hours after infection. – Anixx Mar 20 at 0:05
It seems what is important is whether the latent reservoirs were established. – Anixx Mar 20 at 0:10
It's not the same, since the infant was already infected, which was proven by detecting the HIV Virus on the 20th day after birth (the virus wouldn't persist so long otherwise). The treatment was started so early to give the infant the highest chance to be cured. PEP(post-exposure prophylactis) can prevent infection with HIV. But this was not a prevention, it was a therapeutic approach. This is also a big question in the paper, since a successfully PEP would be no big deal. – NeoDevlin Mar 20 at 0:24
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The authors of the paper claim that there are no latent reservoirs with high probability (by droplet digital PCR and undetectable HIV-specific antibodies). But you can never be 100% assured. Time will tell. But it sounds promising. – NeoDevlin Mar 20 at 0:30
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While it's difficult to prove a negative, I know of no cases where a patient has been treated with HAART to the extent that their viral load never rises again. Keep in mind that, if nothing else, such a study would be extremely hard to do, as proving you've "cured" someone would require extremely long term followup.

HAART is however quite good at suppressing HIV, and there's currently no known upper bound on the lifespan of an HIV+ individual undergoing treatment. Compared to a 10 year post-infection life expectancy a decade or two ago, that's pretty darn good.

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I would add to this that any reported case of this happening, however spurious a publication it appeared in, I'm sure would attract great media attention. When the reports came in of the bone marrow transplant cure, I remember it being reported by the BBC as the 'first cure'. – Rory M♦ Jan 3 at 23:25
@RoryM Indeed - a drug-based 'cure' for HIV is hardly a finding that would go under the radar. – EpiGrad Jan 3 at 23:29

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