But what appeared to matter was not the presence of intact viral genomes, but their location, said Xu Yu, an associate professor of medicine at Harvard Medical School, who led the research.
“We found that in elite controllers, HIV was often found in locations of the human genome that researchers call ‘gene deserts,'” she told AFP.
“In these inactive parts of the human genome, human DNA is never turned on, and thus HIV… remains in a ‘blocked and locked’ state.”
The finding could shift the thinking about how to approach finding a cure for HIV, a disease that an estimated 38 million people lived with in 2019.
In the past, it was assumed that if intact HIV genomes were present then a patient could still become sick.
But the sequencing revealed that even with intact genomes, elite controllers stayed healthy, because the virus was located further from areas called transcriptional start sites, where the virus is more likely to become active and replicate.
The finding “gives us a blueprint of what a functional cure of HIV looks like,” Yu said.
“We don’t have to get rid of all intact HIV sequences in their genomes -– we only need to target those viruses that are located in active parts of the human genome.”
“The remaining sequences… do not seem to cause disease and it looks like they can largely be ignored.”