Researchers at Aarhus University Hospital are hoping to find the key within the immune system that can keep the HIV virus permanently in check—without the need for daily medication. Their initial findings suggest this requires two key components working in tandem: antibodies and T cells.
In a study published in Nature Immunology, the researchers followed patients who stopped taking their daily HIV medication after receiving experimental treatment. In a small group of patients, the virus has not returned.
“We can see that two branches of the immune system work together to control the virus. One targets one aspect of the virus, the other targets another. Together, they are effective enough to prevent the virus from escaping,” said study author Ole Schmeltz Søgaard, professor of infectious diseases at Aarhus University Hospital.
In clinical trials where patients discontinued medication following experimental treatment, something remarkable has been observed: in 10–20% of cases, the virus has not returned. In these patients, the immune system has taken over the role of medication and maintained control of HIV on its own.
The researchers have now identified what sets this group apart from the remaining 80–90%. The key lies in the interaction between antibodies and T cells. In these patients, the two components attack the virus from different angles, preventing it from evading the immune response.
The study followed three patients for up to seven years. Two of them have lived without HIV medication throughout the entire period and remain healthy by all clinical measures. A third patient experienced a viral return after two and a half years without treatment. In this case, the virus had mutated, allowing it to escape both T cells and antibodies.
The research team is now planning new studies focusing on strengthening these immune mechanisms. They will test existing treatments from other disease areas, such as immunotherapy used in certain cancers, which may help enhance the immune response in people living with HIV.
“We have found something that works for 10–20% of patients,” said Søgaard. “Now we need to understand exactly what is happening in their immune systems and use that knowledge to develop a treatment that works for everyone.”
Data from Aarhus University Hospital