Transient immunosuppression during short interruption of HAART: Another key to HIV cure in the “Berlin patient”?

Abstract

Transient immunosuppression in lentiviral infections leads to an auto-vaccination followed by the rise of serum neutralizing activity and a significant decrease in a set-point viral load, which becomes undetectable in some cases. Arguably, in the “Berlin patient” (Hütter G, et al., N Engl J Med, 2009) an induction chemotherapy-mediated transient immunosuppression episode during short interruption of HAART might have led to at least a “functional cure” before allogeneic stem cell transplantation. Neutralization-enhancing RF antibodies (NeRFa) induced as a part of secondary immune response after transient immunosuppression may have played a key role in neutralization of infectious HIV-IgG complexes in extracellular reservoirs. Transient immunosuppression during short non-structured treatment interruption (TI-SNSTI/HAART) regimen would be promising for the achievement of HIV cure on a large scale.