"El caso de Barcelona abre una nueva vía para tratar el VIH"

“The case of Barcelona opens a new way to treat HIV”

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In case of a patient from Barcelona who has managed to control HIV for 15 years without medication It is outstanding. It had never been seen before. This was confirmed by the team from the Hospital Clínic de Barcelona, ​​which is investigating this known case as a result of a study by the August Pi i Sunyer Biomedical Research Institute. This is the follow-up of a woman with an undetectable viral load without the need to take any drug. It is an unprecedented case of “healing” because the virus continues in his cells, but his “exceptional” immune system keeps him at bay.

It is, according to the Hospital Clínic, the only case of functional cure of the HIV virus. As explained in a statement, their cells are “highly resistant to being infected by HIV.” The strong inhibition of the virus is due, according to the hospital, to two types of lymphocytes: the first, the “natural killer” cells, which are part of the innate immune system and are the first line of defense against different pathogens, and the T lymphocytes CD8+, which have a key role in defending cells against the virus.

In conclusion, “Your immune system is exceptional”, according to the Clinic. María José Galindo, head of the infectious diseases unit at the Valencia clinical hospital, explains that this case “opens a new path to explore different treatments against HIV” that were not considered until now. “This woman has special characteristics, and surely genetics is key,” she explained.

The State HIV and AIDS Coordinator (Cesida) has received the news with joy, but at the same time assures that it is necessary to treat it calmly. “It is very good news, but it is still very incipient. It is invaluable information to understand more about what the natural defense mechanisms against HIV are, but there are many years left for this to be applied,” explains Ramón Espacio, general secretary of the organization.

No need for transplant

Yes, there were known cases of HIV cure in the world. Very few. And these have been due to bone marrow or umbilical cord transplants “elite controllers“-people whose immune system defends itself better against HIV-, and not even all the cases worked, only on very few occasions. The novelty of the Barcelona patient is that she is “cured” of the virus, without the need to receive any treatment. In the first cases, it has been possible for the virus to disappear from the body, but not in the most recent one (it is still present in the reservoirs), but a “functional cure” has been achieved.

“This patient’s immune system has some mutation that allows her to control the infection”Galindo says. Hence, he opens a path to explore new therapies. “To begin with, there is no treatment that can be extrapolated to the whole world, neither bone marrow transplants (very expensive and dangerous for people with HIV), nor vaccines, nor gene therapy. The novelty is that joint treatments were being explored,” says the doctor. The case of the patient from Barcelona seems to indicate that research could influence this third way, that of genes.

The strategy is to get the body to distinguish which cells are infected in order to destroy them, and in the case of this patient’s immune system, it seems to have an easier time doing so. “She received very early treatment and is the only one who is still alive today, after the treatment stopped but she did not get worse, but she has managed to control the virus thanks to two types of lymphocytes, the natural killer and CD8+ TGalindo remarks.

Despite the advances, Espacio emphasizes that it is still necessary to advance to eradicate stigmas that, despite the time that the disease has been with us, are still present. “People still have guilt and fear when they are diagnosed, they don’t usually tell their work environments and they think a lot to see who I tell or not,” assures the general secretary of Cesida.

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