US Pharm. 2013;38(11)(Oncol. suppl):S-14.

Scientists may now have more insight into why some patients are able to control the HIV virus long term without the help of antiviral drugs, a finding that may result in shortened drug-treatment regimens for others with HIV.

Individuals who do not require medicine have a larger amount of an immune protein, A3, which blocks HIV from spreading, researchers from Northwestern Medicine report. Scientists have been trying to find out why 1% of people with HIV—called controllers—are able to control the virus without medications, sometimes for their entire lives. The virus rapidly destroys the controllers’ initial defense against HIV, and a second line of defense deep in the immune system backs up the short-lived, early defense, according to the Northwestern scientists.

This discovery suggests a novel approach involving much earlier treatment that could potentially make every HIV-infected person into a controller for the long term by protecting the reserves of this defensive immune protein. The goal would be for infected individuals to eventually be free from antiretroviral drugs.

“Preserving and even increasing this defense in cells may make more HIV-infected persons into controllers and prevent HIV from rebounding to high and damaging levels when anti-HIV medications are stopped,” said Richard D’Aquila, MD, director of the Northwestern HIV Translational Research Center. He is the senior author of the study, published October 16, 2013, in the journal PLOS ONE.