A Spanish woman with HIV has been controlling the virus at undetectable levels spontaneously without medication for over 15 years. Reporting the news seems simple, but the implications are huge. First of all, as Josep Mallolas, head of the HIV-AIDS Unit at the Barcelona Clinic, “were able to find out what the possible mechanism was that allowed this”. This brings us definitively closer to a functional cure for AIDS.

What do we know about the case? While full details of the case will be presented at the 24th International AIDS Conference in Montreal this week, the Hospital Clinic team held a press conference to announce what they described as a “unique” and “extraordinary” case of functional treatment. A disease that affects more than 37 million people worldwide.

The “Barcelona patient” (who is understandably kept anonymous) was diagnosed in 2006, they explained. It was then selected for a clinical trial used to complement the effect of certain immunomodulatory treatments (eg, cilosporin A). antiretrovirals and strengthen the immune system. Nine months was enough for the patient to lower his blood viral load to an “undetectable” level. After 15 years, 50 analyses, the burden remained, despite not taking medication.

Why is it relevant? Diseases are complex relational phenomena, and if we examine them on a case-by-case basis, we find, in short, striking things that deal with a particular case rather than something we can use against the disease in question. With the “Barcelona patient”, researchers long believed they were in this state. Of the 20 who received this treatment, she was the only participant to react this way.

In fact, when they examined the patient’s CD4+ T lymphocytes (although they were the main targets of the virus), they found no significant difference. After much thought, they discovered that the key is not in CD4+, but in NK cells (“Natural Killer” or “natural killers”) and CD8+ T lymphocytes.

What effects does it have? The team, of course, did not stop there. He was able to identify what types of NK and CD8+ cells were behind this highly effective sign of HIV. In other words: they were able to identify the mechanism by which the immune system was able to control infection, and this opens up tremendous avenues for moving towards a functional cure for AIDS.

“Functional” is important. As the researchers point out, what the patient is doing is controlling the replication of the patient’s HIV without the need for treatment. saying this rudelythe patient has their own natural antiretrovirals, but the infection is still there (CD4+ cells continue to retain their ability to replicate the virus intact)

back then? Is it really that important? True yes. Until now, the ways in which we had to “cure” the disease required treatments so aggressive, complex and expensive that they made large-scale treatment impossible. If the researchers at the clinic are right and we learn to activate this control mechanism, the situation will change drastically. There is still a lot of work to be done, but today is a good day to celebrate hope.

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