The news in July that HIV had returned in a Mississippi toddler after a two-year treatment-free remission dashed the hopes of clinicians, HIV researchers and the public at large tantalized by the possibility of a cure.
But a new commentary by two leading HIV experts at Johns Hopkins argues that despite its disappointing outcome, the Mississippi case and two other recent HIV “rebounds” in adults, have yielded critical lessons about the virus’ most perplexing-and maddening-feature: its ability to form cure-defying viral hideouts.
Writing in the Aug. 28 issue of the journalScience, HIV research duo Robert Siliciano, M.D., Ph.D., and Janet Siliciano, Ph.D., note that such “failures” are in fact stepping stones to new understanding of what “cure” may look like and new therapies that tame the virus into long-term remission.
“Heartbreaking as these three cases are clinically, they provide a dramatic illustration of the real barrier to an HIV cure and illuminate important therapeutic strategies,” says Robert Siliciano. “This is not the end of the story but the beginning of a new chapter.”
The 27-month off-treatment remission experienced by the Mississippi toddler is, in and of itself, a laudable therapeutic goal, the Silicianos write, and is what cure of HIV may look like in the foreseeable future. Finding ways to induce long-term remission and to closely monitor its course will be the next frontier in HIV treatment, they write.
Ekaterina Pesheva
Medical Press
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