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Six years ago, infectious disease specialist Ricardo Diaz devoted the majority of his time to solving a global problem: HIV infection. And he may be getting closer to healing, as the preliminary results of his experiment, obtained by BBC News Brazil
Diaz, who is a researcher at the Unifesp School of Medicine, have conducted a study that, l & # 39; 39 last year, to completely eradicate the HIV virus from two HIV-positive people, according to the results.
Now they are being watched to see how their bodies react without experimental treatment.
The study has not yet been published, but will be presented in its entirety, for the first time at the International Congress on AIDS, the largest in the world on the subject, taking place in the country. Low from Monday.
Infectionist Melissa Medeiros, HIV expert and consultant at the Brazilian Society of Infectious Diseases, this research is "extremely promising" and "brings hope, above all". However, he says we must go through the tests to find out what the impact of the treatment will be on people.
"When you talk about something like that, people already think that healing has come in. But it is important to know at least five to ten years, until research reaches the population.It takes a long time to know if the research will be successful and if it is safe, "a- he told BBC News Brazil
HIV Treatment
Currently available anti-HIV treatment in the Brazilian Unified Health System (SUS) is a badtail of three drugs that inhibits as much as possible reproduction of the virus in the body while preserving the immune system.
The Brazilian team of researchers made a combination of drugs already used around the world with two other sub.
"This is the first time in the world that someone is experimenting with this specific treatment that we have done, and the first time we have such positive results in the world." Step One. "In 2015 , a Danish study combined a drug used in the treatment of cancer with the antiretroviral badtail and a DNA-based vaccine and managed to eliminate the reservoirs. Since then, other tests of this type have been carried out in Spain, Great Britain, Norway, Germany and Italy, and begin to occur in the United States [19659002] The first step of the 39; Diaz study – performed with 30 people – was completed, with only five of them receiving the full combination of treatments, and two of them appear to be free of the virus, according to tests.
The treatment proposed by Brazilian researchers wants to achieve the "sterilization treatment", which is the suppression virus, with no possibility of recurrence – something that can actually happen if the HIV-positive person stops taking the badtail .
"Today, we treat the person, the virus dies, we stop treating, and the virus back.This is because the virus continues to multiply in the body even with a treatment effective, "says the infectiologist
. According to Diaz, the total cure of HIV patients faces three major hurdles – the fact that the virus continues to replicate in the body even with the badtail, which does not that maintain this weak replication, the fact that the virus is latent, that is to say, "dormant", and can return to the activity in a random manner, and the existence of "sanctuaries"
What we did was combine treatments able to overcome all these barriers.The study was initially done on 30 patients, divided in groups of five, each of them knowing a different combination, and the last group used all the treatments together.
In addition to the roviral antiretroviral badtail, they used nicotinamide, or vitamin B3, a food supplement sold in pharmacies but never used against the HIV virus.
Research has also used gold salt, a drug used to treat diseases such as arthritis that does not even wake up HIV-infected cells, but that leads to "suicide." says Diaz.
In order to eliminate the "sanctuaries" of viruses in the body of patients, the researchers developed, in partnership with the University of São Paulo (USP), a complex personalized vaccine that causes the immune system .
"We designed, based on the genetic profile of the person, the small part of the virus that would be important to awaken the immune system," says the infectiologist.
In the five persons in group 6 who completed the treatment, the amount of virus decreased more than in all the others.
"We are now studying how to stop this treatment to see if they remain virus free longer, and then we will extend the study."
The first man considered to be cured of HIV in the world, American Timothy Ray Brown, was declared free from the virus in 2006 after receiving the bone marrow from a donor carrier. 39, a rare genetic mutation, which made him immune to the virus.
Brown needed the transplant because he had leukemia. In 2008, the disease returned and he had to have a second bone marrow transplant. But according to experts, this does not mean that a bone marrow transplant would solve the cases of all HIV-positive people in the world – about 37 million in 2017, according to the UN "
" Timothy Brown is a rare and very specific case because he was lucky to find a bone marrow donor with a very rare genetic mutation that prevents the body's defense cells from binding to "
" But what transplant type has a 50% mortality rate, this is not a therapeutic option for all people who have HIV. "
So, in recent years, scientists around the world have invested in research like the one conducted by Diaz, where people already on treatment to control the virus receive additional drugs and a specific vaccine.
" Being HIV-positive, it's living in silence because people feel they can not tell their family or friends, live in fear of new relationships, see how society will be accepted at work, and so on.Healing can still take a while, but it is essential, "says Melissa Medeiros
Need to Invest in AIDS Prevention
But for the epidemiologist Lígia Kerr, who produces HIV studies For the Ministry of Health, it takes more than medical treatment to solve the problem of AIDS in the world.
"The prog Technological achievements in the treatment and healing of AIDS are welcome, but it is not only them who will control the situation. If you have a very expensive treatment and governments are no longer willing to invest in health, it is difficult, "he told BBC News in Brazil
.
" Some researchers like me do not believe in this total cure for AIDS because it involves not only drugs, but also a behavior, a commitment to the other, the use of condoms, the investment of patients and medical treatment. governments. "
" We have tried to completely eliminate other diseases for years and we can not. For example, leprosy. It's a treatable disease, but if you do not treat everyone, there's no way. The bacillus will always infect other people. "
If successful, HIV treatment would be very expensive?
Diaz states that a personalized vaccine for every HIV-positive patient in Brazil – and in the world – would be very expensive, even though it's not a real estimate of the amount spent on his research up here. "
" There are other things in health that are expensive, but when they see praxis, are done faster, we have several examples in medicine. "
For Melissa Medeiros, the high cost of treatment could be offset in her scale of production if the final results of research really mean a definitive cure . The government has already bought battles like this one, like hepatitis C. The treatment cures almost 100% of people, and it's not cheap. It costs between R $ 100,000 and R300,000 per patient, but the Ministry provides for free. "
The controversy of the study made only with men
Participating in the study Unifesp, it was necessary that the HIV-positive were all over 18 years old and male, which means that researchers still do not know how treatment can work in women.For this reason, Diaz admits that he was "very criticized."
"This is not a good thing to make this discrimination. We must investigate for all individuals. But I had the intuition that, at that time, it would be safer to only do with men. "
" I thought that for some medications, there could be more side effects in women. Women sometimes get pregnant and we did not know what this combination could do. But it is already in the plan to include women in the next step. "
According to the infectiologist, experimental treatments against the HIV virus usually have 75% of male patients and 25% of women, who are generally infected at a lower rate number
However, their study must obey the new guideline in the scientific community to have the same number of women and men
BBC Brasil – All rights reserved – Reproduction without written permission of BBC
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