HIV trial in SA shows long-term control without daily meds

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South African scientists have announced promising results from a pioneering HIV cure trial involving women, offering hope for long-term control of the virus without daily antiretroviral therapy (ART).

HIV Trial Details

According to Mail&Guardian, the Africa Health Research Institute (AHRI) and the Fresh clinic in Umlazi ran the small but significant study.

The study found that 20% of women who took part were able to keep the virus suppressed without needing daily antiretroviral treatment (ART), something researchers say is a first for Africa.

“These women stopped taking their antiretroviral medication, and for up to 18 months in one case, two and a half years the virus did not come back,” said Professor Thumbi Ndung’u, the study’s lead investigator. “It’s not a cure yet, but it’s a clear step in that direction.”

The trial, which ran from mid-2022 to early 2024, involved 20 women between the ages of 23 and 32 who had been living with HIV for several years.

All had started treatment the day they were diagnosed a detail researchers believe made a major difference in how their immune systems later responded.

Results

Participants stopped taking ART and instead received a combination of two broadly neutralising antibodies – VRC07-523LS and CAP256V2LS – and a third compound, Vesatolimod, designed to “wake up” the immune system to recognise and fight HIV.

Medical teams closely monitored the women. If their viral load, the amount of virus in their blood, crossed a certain threshold, the teams put them back on treatment.

Of the 20 women who took part in the trial, four were able to suppress the virus for at least 18 months without restarting treatment.

Another six managed to remain off medication for the full 44 weeks of the study, showing no signs of damage to their immune systems.

The remaining participants did experience a return of the virus during the trial, but none faced serious health complications, and importantly, none developed resistance to the antiretroviral drugs once they resumed treatment.

Why This Matters

According to UNAIDS, sub-Saharan Africa accounts for around 67% of global HIV cases, with women representing more than half of those infected.

Despite this, most HIV clinical trials still underrepresent women.

Professor Krista Dong, who helped run the trial at the Fresh clinic, said women in the region often have very different experiences with treatment than their counterparts overseas.

What’s Next?

While the current treatment combination used in the trial won’t move into large-scale testing just yet, researchers are hopeful it has paved the way for new ideas especially those focused on long-term, treatment-free control of HIV.

He stressed that researchers need to conduct further studies to determine whether they can improve and replicate this kind of viral control on a wider scale.

“This isn’t the end it’s the beginning of something,” he said.

The four women who remain off ART continue to undergo monitoring with regular clinic visits to ensure their health stays stable.