New Trends Towards HIV Cure Research
Toulon, France, September 09, 2011 -- Fifteen years after the advent of combined antiretroviral therapy (ART) life expectancy of HIV-infected patients, as well as their quality of life, have considerably improved. However, ART remains a life long battle as these therapies are unable to eradicate the virus. Although we can still improve tolerance and acceptability of ART, the next decisive step would be to find a cure. Specific budget lines have been created in 2010 and the first eradication trials have just been launched.
The year 2010 will remain a turning point in the search of an HIV cure for 4 reasons. First, at the Conference on Retroviruses and Opportunistic Infections (CROI) held in San Francisco in February, Professor Antony Fauci, head of the NIAID (National Institutes of Allergy and Infectious Diseases) stated that a cure was no longer a taboo. Then, both the NIH (National Institutes of Health) and the amfAR (American Foundation for AIDS Research) announced specific grants for HIV cure research. Next, in July, the IAS (International AIDS Society) launched a global initiative called “Towards an HIV Cure” and formed a working group coordinated by Professor Francoise Barre-Sinoussi. This group will formulate specific recommendations for HIV cure research. Finally, in December, was published the cure of the “Berlin patient” following 2 bone marrow transplants with a donor bearing the delta 32 mutation on the CCR5 gene.
Almost one year later, where is HIV cure going? Around 10 pilot trials have been already been launched and a couple of additional trials are being finalized. Different approaches are tested. First, “mega-ART” (5 drugs rather than 3) are tested at acute HIV infection to see if it can increase the likelihood of post-treatment control (no rebound in viremia after ART is stopped: functional cure). Second, the “purge” approach is on track. Two trials are using SAHA (vorinostat), an HDAC inhibitor, to reverse HIV from latency and deplete the HIV reservoir. However, due to safety and tolerance issues, these initial trials are not designed to purge the reservoir in depth but to assess the effect of short SAHA courses on viral expression. Another trial is testing disulfiram, and another interleukin-7 (IL-7), with the same objective. Third, gene therapy trials are ongoing using zinc finger nucleases to knock down CCR5 expression and create an immune system resistant to HIV.
All these strategies will be discussed next December during the “5th International Workshop on HIV Persistence, Reservoirs and Eradication Strategies” to be held in Sin Maarten. This meeting of the minds will be a cornerstone in the search of an HIV cure.
Almost one year later, where is HIV cure going? Around 10 pilot trials have been already been launched and a couple of additional trials are being finalized. Different approaches are tested. First,
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