‘Functional cure’ for HIV linked to early drug treatment

A French medical study involving 14 people with HIV who discontinued drug therapy for years without becoming ill may provide new clues for controlling the virus that causes AIDS.

The study, published Friday in PLoS Pathogens, follows news earlier this month that an infant in Mississippi was “functionally cured” of an HIV infection following immediate treatment with a cocktail of antiretroviral drugs.

While authors of the French study could not explain precisely why the 14 patients were able to keep the virus in check naturally, they said it was likely related to the fact that they began drug therapy within 10 weeks of infection.

The question of whether powerful drugs should be administered very soon after infection with HIV has been hotly debated. Critics argue that early combination antiretroviral therapy, or cART, is expensive and poses a risk of long-term toxicity and viral resistance.

However, lead study author Asier Saez-Cirion, an HIV researcher at the Institut Pasteur in Paris, wrote that early drug therapy is highly effective.

“Early treatment initiation improves survival and reduces risk of HIV transmission,” wrote Saez-Cirion and colleagues. “These findings argue in favor of early cART initiation.”

On average, the 14 HIV patients underwent drug therapy for three years before electing to stop taking the drugs for a period of more than seven years. Normally, those with HIV who discontinue drug treatment see a quick rebound in viral activity, but these particular patients did not.

Although the 14 remain infected with the virus, their own immune systems are able to keep the virus in check. Such patients are uncommon and are considered to be functionally cured.

Study authors estimated that only 5% to 15% of all patients who discontinue drug therapy are able to control the infection naturally.

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