‘HIV elite controllers’ in DRC spark hope for new treatments, cure

A recent finding in the Democratic Republic of Congo of an unusually large number of people with HIV who naturally control their viral loads without medication, has sparked hope in the scientific community.

The “groundbreaking” finding of over 10,000 potential “HIV elite controllers” (with low viral-loads) is expected to help scientists focus their attention on this subset of people, to map trends that could lead to new treatments for HIV.

“It gives us a lot of hope because it means that instead of just a few people as seen in earlier studies, this shows 1000s of people in DRC, who could be teaching us about how we could unlock a cure or develop better vaccines to end HIV,” Mary Rodgers, principal scientist and head of the Global Viral Surveillance Program, Abbott (Diagnostics), told BusinessLine.

Explaining the implications of the findings, she said, “if we can understand which part of their immune response was responsible for that, it can help develop vaccines that are tailored for that kind of an immune response.” Rodgers is co-author of a study published on this in EbioMedicine (The Lancet) on Tuesday. It’s been about 35 years and an AIDS vaccine has eluded the research community.

The finding may not have an immediate connect with India, but Rodgers points out, “HIV has its origin in DRC and Cameroon and so it could follow that the potential cure and the ability to suppress HIV also has its origins in this part of the world”. Abbott was the first to develop an approved FDA test for HIV more than thirty years ago.

Additional studies

Researchers from Abbott, Johns Hopkins, National Institute of Allergy and Infectious Diseases, University of Missouri – Kansas City and the Université Protestante au Congo found that the prevalence of HIV elite controllers was 2.7-4.3 per cent in the DRC – compared to 0.1-2 per cent prevalence worldwide.

Pointing out that additional studies will be required to understand this unique immune response, Abbott said, findings from the study “could lead researchers closer to their goal of ending the HIV pandemic by uncovering links between natural virus suppression and future treatments.”

Abbott’s surveillance programme has been around for 26 years, studying HIV and its mutations to help design diagnostic tests to stay ahead of the virus, Rodgers said. And the intriguing twist to the latest finding is that the “elite” trend was seen in samples collected in 1987 - the beginning of when this became a global pandemic. “So this tells us that it has always been there ... we just never knew about it,” she said.

“Plasma samples from surveillance efforts collected in 1987, 2001-03 and 2017-19 in the DRC – home to the oldest known HIV strains – allowed researchers to rule out false positives, collection site bias, high genetic diversity and anti-retroviral treatment as the cause of non-detectable viral counts in 10,457 patients from 2017 to 2019,” the note explained.

About 38 million people today are living with HIV. And the latest findings from Abbott researchers and partners are a continuation of virus hunting efforts that led to the identification of a new strain of HIV in 2019.