April 25, 2012
Report Outlines HIV Cure Research, Important Gaps
by Tim Horn
Three HIV/AIDS activist groups convened a meeting in March with researchers and representatives of the U.S. Food and Drug Administration (FDA) to describe the current state of cure research and identify barriers to moving such research forward swiftly and smoothly. The proceedings of this meeting, which took place immediately before the 19th Conference on Retroviruses and Opportunistic Infections (CROI) that began on March 5 in Seattle, are now available in a report online.
“A cure for HIV will be essential to ending the AIDS pandemic, but science that is focused directly on a cure is still in early stages and will likely require the support of multiple stakeholders to proceed at the fastest pace,” reads the executive summary of the report, authored by David Evans, Kevin Fisher, Jeff Taylor and Siegfried Schwarze.
In the past four years, the report notes, there have been signs of increasing scientific momentum and funding directed toward curing HIV infection.
The remarkable case of “Berlin Patient” Timothy Brown—a man who all signs suggest has been cured of HIV—has catalyzed and expanded what was once a small and somewhat fragmented effort to understand how HIV persists despite effective antiretroviral (ARV) therapy and to explore mechanisms to eliminate the hidden pool of virus in people on ARV treatment (a sterilizing cure) or to enable the immune system to control HIV without the need for ARVs (a functional cure).
This momentum, the activists write, has been greatly enhanced by the NIH-funded Martin Delaney Collaboratory projects, partnerships between academia and industry focused on the possibility of discovering and developing a safe, effective, feasible and scalable HIV cure.
Among recent signs of progress, researchers have contributed new insights into where and why HIV persists despite potent ARV therapy. In addition, the first controlled clinical trials of drugs to activate cells harboring archived HIV, such as histone deacetylase (HDAC) inhibitors, are yielding promising signals, and other types of treatments designed to teach the immune system to either clear or control the virus on its own have been initiated.
But central questions remain, the report stresses.
For example, it is still not clear what types of cells and anatomical compartments harbor HIV, nor is it understood which methods work best for measuring the latent virus in these reservoirs. Knowledge regarding how HIV is able to replenish these reservoirs, even when ARVs with “maximally suppressive” effects on viral load are being used consistently and correctly, is also needed. Actually, it’s not entirely clear if modern ARV therapy is, in fact, fully suppressing HIV replication. And does the immune system play a role in HIV persistence? In addition, what are the forms of immunologic HIV control that can potentially be enhanced without major safety issues?
Finally, the report asks, what are “reasonable” risks for the people living with HIV who will be participating in early—and potentially dangerous—studies, and how can these individuals be best protected?
To address these questions, members of the AIDS Treatment Activists Coalition (ATAC), the Treatment Action Group (TAG) and Project Inform sat down with several industry and academic researchers on March 4 in Seattle, who described their current projects, outlined the obstacles and facilitators to cure research and offered suggestions for the kinds of activities that community advocates might undertake to overcome current obstacles.
Highlights include: an overview of AIDS Clinical Trials Group (ACTG) clinical trial development by Dan Kuritzkes, MD; laboratory testing for new compounds, including work being conducted by Romas Geleziunas, PhD, at Gilead Sciences; the prospects of gene therapy, notably ongoing zinc finger nuclease work at Sangamo Biosciences, discussed by Dale Ando, MD; stem cell research after the Berlin Patient, highlighted by John Zaia, MD, who underscored the importance of not overselling this approach; and work focusing on the enhancement of immune responses, reviewed by Pablo Tebas, MD.
The post-meeting report, issued in April, provides a brief synopsis of each presentation, followed by an outline of areas identified by the workshop speakers and participants for further exploration, development and incorporation into a cure advocacy agenda.
“The prevailing view of all the speakers was that we must not raise premature and unrealistic hopes of a cure for HIV either in people who volunteer their bodies for cure research, or in the wider community of people with HIV and their allies,” the authors write. “Critical early steps have been identified, but we need many more successes in analytics, basic science and translational research—in both animals and people—before the cure will be within our grasp.”
Search: cure, research, science, advocacy, activism, treatment action group, tag, aids treatment activists coalition, atac, project inform, gene therapy, immune-based therapy, stem cells, therapeutic vaccines
Scroll down to comment on this story.
comments 1 - 14 (of 14 total)
David, Palm Springs, 2012-07-02 22:21:13
I've been taking these nasty pills for at least 18 years. There is no fun in these pills as they have and are contributing to my nerve damage and lipoatrophy. While a cure or functional cure might be great, I'd hope they come up with better solutions for my nerve problems than taking Lyrica forever.
keith, dublin, 2012-06-09 13:02:54
That is why part of me feels the cure functional or otherwise will come from Europe
HIV was discovered by French scientists, the Berlin patient was obviously in Europe.
This Vacc 4x (which I have faith in) is coming from Norway and now we have tests on cord blood in Amsterdam and Madrid with the hope to cure HIV.
I feel Europe will cure this illness.
I also feel HAART will be gone within 5 years replaced with bi anual injection like Vacc 4x.
I hope anyway.
TheDevilIsStupid, , 2012-05-23 03:01:53
re - Devilsadvocate, I'm so sick of that argument. Do you realize how ridiculous that is? 34 million people in this world are living with HIV/AIDS, and there are tons of treatments available spread throughout all of the pharmaceutical companies. If one company comes up with a cure, all other treatments will become obsolete and they will have a monopoly on a 34 million person market. They're salivating at the thought. Don't kid yourself.
Devilsadvocate, , 2012-05-10 10:36:56
To play the devil's advocate, a cure could sound the death knell to the multi-billion dollar AIDS industry. the pharmaceutical industry in the US i simply too powerful to let that happen. Compassion is simply not a factor as far as profits go.
HiHunter, Dunn, North Carolina, 2012-05-08 10:22:33
Hooray for the research thus this far and a long way to go. Please participate and do you part in findinf a CURE.!!
Son, Stuttgart, 2012-05-06 07:56:04
There are major medical advances in HIV medication, but the fact is a ton of positive people still do not have access to these medications. HIV is a terrible disease but it has made a group without borders, regardless if you're in Japan, USA, South Africa, Germany, Peru, China. There are positive people everywhere, and we all want a cure. Once we get that cure, which i'm sure will be soon, it will be a victory for all mankind, hopefully it unify all man. It will be bigger than the moon landing.
Rio, , 2012-05-03 13:59:29
I wish they found the cure, or a better treatment soon enough, I pray to God to bless these people who try to found a way somehow...
avis, everret, 2012-05-02 23:30:25
notice how they always say a cure will take decade to come its so freaking crazy that i've first heard this at 17 i am not 2 decades earlier, so what is truly going on? and why is it that everytime the release this breaking news they get your hopes up then at the very it the repeat this is just a big step but a cure could take decades, let get it correct for once it may take another century because 3 decade have already passed
Tim Horn, AIDSmeds, New York, 2012-05-02 15:14:34
Dennis, I don't think anyone is saying the major advances of the past two decades aren't to be celebrated, but there are many who are highly treatment experienced and choking down complex regimens, we're still at an increased risk for non-AIDS health problems, lifelong treatment is prohibitively expensive for many and side effects are the rule, not the exception. We've done good, that's for sure -- but we can certainly do much, much better.
chris, SA, 2012-05-02 13:09:48
Press foward with cure is the only way to end this diseas. Don't despair keep going, the pills people do swallow have lonterm organ damage.
dennis rozycki, monroe,mi, 2012-05-02 08:39:28
I don't understand some of these comments. I am hiv positive and i now take one pill a day which is like a cure for me. I take one pill a day with no side effects that enables me to live my life as normal as i did before hiv and probably for a normal lifespan. 15 years ago we didnt have this. We need to celebrate that instead of acting as if research has gotten nowhere.i thank god everyday as i swallow my pill.
mitch, , 2012-04-30 09:08:41
well, yes, at the current pace, a cure IS decades away. HIV cure research has to be one of the most underfunded, underreported fields in modern history, relative to its impact on humanity and how close we are already to it.
BettyForACure, , 2012-04-26 10:25:12
I don't think a 'functional cure' is decades away. Maybe I am being overly optimistic but I believe a major breakthrough will emerge in the next 7-10 years. A one pill cure treatment is def decades off, but I strongly believe HIV will be treated much like cancer. Keep faith, support and advocate where you can. It will happen!!
Ranjan, Hyderabad, 2012-04-26 04:27:04
comments 1 - 14 (of 14 total)
This is an excellent move and I hope something is done in taking the research forward to finding a cure. There has been a flurry of developments from across the world but only to add that any cure is decades away. Can they imagine how demoralising it is to hear breakthroughs but one has to wait for decades. What will it take to speed it up. What if a disease strikes which will wipe out mankind. Will they still be as slow.
[Go to top]