A few weeks ago, American scientists announced that a woman treated in New York, suffering from leukemia, was cured of AIDS after receiving umbilical cord blood stem cells.

Before her, three patients in Berlin, London and Düsseldorf had also been presented as cured, after a bone marrow transplant intended to treat their cancer.

This transplant from a compatible donor, whose cells were resistant to HIV, in fact made it possible to replace the blood cells of the infected patient and to reconstitute a new immune system for him.

Have we finally found a treatment to cure the human immunodeficiency virus?

In no case, because these are heavy operations, impossible to replicate on a large scale.

Since the HIV virus was isolated in 1983 by the team of Françoise Barré-Fitoussi and Luc Montagnier, science has made giant strides.

In 1996, the first tritherapies - a combination of three drugs - notably enabled AIDS patients to live with the virus more or less normally.

But, while the weekend of Sidaction starts Friday, the organizers are moved that the health crisis continues to weaken the activities of fight against AIDS in France and abroad.

Françoise Barré-Sinoussi, co-discoverer of the virus with Luc Montagnier, Nobel Prize 2008 and president of Sidaction, during a press conference dedicated to Sidaction, March 7, 2022 in Paris Christophe ARCHAMBAULT AFP / Archives

And if tritherapies have the merit of existing, they are not insignificant.

There is a higher risk of developing other diseases (cardiovascular, cancer, etc.), access problems, sometimes resistance to treatment, recalled in mid-March Michaela Müller-Trutwin, professor at the Institut Pasteur, on the sidelines of a colloquium of the ANRS-MIE (the French research agency on AIDS and infectious diseases).

"Natural killers"

These drugs must also be taken "for life".

"Today, patients tell us that they would like a treatment that they can stop," Françoise Barré-Sinoussi told AFP.

"If they are expecting this, well it must be done".

Some patients, treated very early with antiretrovirals, were able, after stopping treatment, to “naturally control the infection”.

A very small proportion of patients, infected for a long time with HIV, also manage to live without treatment, no doubt thanks to genetic particularities allowing their immune system to control the virus.

"From these few cases, we can better understand what are the mechanisms that a therapeutic strategy must take into account", underlined Ms. Barré-Sinoussi.

The Wall of Memory dedicated to those who died of AIDS in Lincoln Park, December 1, 2021 in Los Angeles Frederic J. BROWN AFP / Archives

"More and more data show, for example, the important role played by NK (natural killer) cells", lymphocytes of the innate immune system capable of killing infected cells, she illustrated.

New approaches, based on gene therapy or immunotherapy, are also now being studied to modify the cells or the receptors of the virus, she explained.

But can we therefore envisage a total cure for patients infected with HIV?

"That would mean that there are no more infected cells in the body at all, and that seems unlikely," replied Jennifer Gorwood, a post-doctoral fellow at the Karolinska Institute in Stockholm, Sweden.

The problem with HIV is that it inserts itself in a dormant, latent form in the cells, "and that it can be reactivated, for example when we stop treatment", she continued.

It therefore seems more realistic to hope in the long term for a "remission" of HIV which would mean that, even while remaining in the body of a patient, it no longer expresses itself.

"At the start, we thought that we had to eradicate the virus 100%, we are beginning to understand that it may be enough to introduce barriers" to control it, by making cells resistant or by stimulating the immune system, underlined Michaela Muller-Trutwin.

An achievable goal, but one that could take decades.

© 2022 AFP