HIV Cure Trial Results: 4 Women Remain Virus-Free After Stopping Treatment in SA

This milestone study, conducted between July 2022 and January 2024, involved 20 women aged 23 to 32 from the Females Rising through Education, Support and Health (Fresh) clinic in Umlazi, KwaZulu-Natal. All participants were HIV-positive and had started ART within a day of their diagnosis.

South Africa Leads with First-of-Its-Kind HIV Cure Trial

The participants in the study had been on ART for at least six years before the trial. When the study began, they stopped taking ARVs and instead received an “intervention” comprising three different products. The goal was to test whether these new interventions could control HIV without the need for daily ART.

The intervention included:

• VRC07-523LS and CAP256V2LS – two broadly neutralising antibodies that bind to HIV and prevent it from infecting cells.

• Vesatolimod – an immune-stimulating drug that binds to human immune cells and enhances the body’s response against HIV.

Viral Suppression Achieved in 4 Women After Stopping ART

The HIV cure trial results were remarkable. Four of the 20 women were able to maintain an undetectable viral load—a level of fewer than 200 copies of HIV per millilitre of blood—without resuming ART. These women remained healthy and continued to show no signs of viral rebound up to 18 months after stopping treatment. One woman even maintained suppression for 2.5 years.

The remaining 16 women experienced a return of detectable virus and were safely reintroduced to ART. Seven had a viral rebound within 16 weeks, and another seven between 16 and 44 weeks. In all cases, there were no signs of drug resistance, and CD4 counts remained above the danger threshold of 350.

Trial Emphasised Safety, Efficacy and Female Representation

The trial was spearheaded by Professor Thumbi Ndung’u of the University of KwaZulu-Natal’s Africa Health Research Institute. Ndung’u stressed that while the findings are not yet a definitive cure for HIV, they represent a “step in the right direction.”

“We cannot call this a cure, as only 20% showed long-term viral suppression, but it gives us a platform to improve and perhaps reach 50% or more in future trials,” he said.

Ndung’u also emphasized the importance of conducting the study in Africa with women, who are often underrepresented in HIV cure trials globally.

“Women make up less than 20% of HIV cure trial participants worldwide. Yet, sub-Saharan Africa accounts for 67% of global HIV cases, and 53% of these are women,” he stated.

Importance of Early Treatment and Immune Readiness

Another key takeaway from the HIV cure trial results was the importance of early intervention. All women in the study had begun ART within 24 hours of diagnosis, a factor that researchers believe contributed to their immune systems’ ability to suppress the virus without medication.

Their CD4 counts—a marker for immune health—were all above 500 at the start of the trial, and none dropped below 350 even after stopping treatment. This showed that their immune systems were strong enough to manage the virus with help from the new intervention.

Social and Cultural Context Shapes HIV Treatment in Africa

Professor Krista Dong of the Fresh clinic highlighted that conducting research in local contexts is crucial. She pointed out that strategies successful in Western countries may not translate to African settings.

“Women in Umlazi may prefer injections to daily pills, unlike someone in San Francisco. We must develop treatments that are effective and acceptable within their cultural and social environment,” she explained.

A Promising Start Towards Long-Term HIV Control

Though still in early stages, these HIV cure trial results offer a glimmer of hope for millions affected by HIV—especially in sub-Saharan Africa. The trial proves that long-term viral suppression without daily medication is possible for some people living with HIV.

The research team is now aiming to improve the success rate and explore other combinations of immune-based therapies. While the specific product used in this study may not move forward, the door has been opened for further innovative approaches tailored to African populations.