It’s
been more than 30 years since HIV/AIDS was first discovered. It was in
the year 1981, when a new syndrome, the acquired immune deficiency
syndrome (AIDS), was first recognised among homosexual men in the United
States.
By 1983, the etiological agent, the human immunodeficiency virus (HIV), had been identified.
By the mid-1980’s, it became clear that the virus had spread, largely unnoticed, throughout most of the world, (UNAIDS, 2003). This implies that researchers have been in and out of the laboratories for three decades, searching for an HIV/AIDS cure.
The discovery of the antiretroviral drug has been a huge breakthrough. How far are we from the HIV/AIDS cure? Seemingly there’s light at the end of the tunnel. Researchers are gaining good momentum and promising results. We can’t say the cure will be available in three years time, but we can’t be shocked if it could be discovered within the next three to four years. Don’t lose hope. Hangon there! For now, just stick to your doctor’s prescriptions. Good days are just by the corner.
ONLY ONE BABY CURED OF HIV/ AIDS TO DATE
The very recent case of HIV cure in a baby flagged on March 3, 2013 is an important benchmark in HIV research. Doctors at the Johns Hopkins Children’s Centre, Mississippi, USA, announced this as a case of ‘functional cure’, meaning that the virus did not rebound even after discontinuation of the antiretroviral treatment (ART). The baby, born in Mississippi, was detected to be HIV infected by HIV DNA and RNA testing on the 2nd day of life.
She was put on ART soon after the diagnosis at about 30hrs after birth and continued until 18 months of age.
HIV plasma viral load tests for the child were positive on several occasions before reaching an undetectable level at 29 days. HIV remained undetectable at 26 months despite ART being stopped at 18 months. Although some ultrasensitive tests could detect low copies of the virus in her cells, standard clinical assays like plasma viral load, peripheral blood mononuclear cells (PBMC) DNA, and HIV-specific antibodies failed to detect traces of the virus confirming a state of ‘functional cure, (Indian J Med Res 138, December 2013, pp 824-828).
ONE ADULT HAS BEEN SUCCESSFULLY CURED OF HIV/AIDS TO DATE
The report of a single patient cured of HIV with hematopoietic stem cell (HSC) transplant has raised tremendous hope, excitement, and curiosity in the field.
The patient had HIV infection and leukaemia and was transplanted in Berlin in 2007 using HSCs from a donor whose cells lacked the functional CCR5 co-receptor required for HIV to infect cells.
Following the transplant, his antiretroviral therapy was stopped and his blood and various biopsy specimens showed no detectable HIV, suggesting that he might be cured.
However, it is not certain how functional cure was achieved with the ‘Berlin Patient’: it could be attributable to some combination of the transplant conditioning regimen, the anti–T-cell chemotherapy, graft-versus-host effect, and/or other factors in addition to the lack of a functional CCR5 co-receptor. In addition to the Berlin patient, there have been early-stage clinical studies of engineered human progenitor cells and T cells expressing anti-HIV moieties, including CCR5-inactivated T cells. These studies demonstrated the safety and feasibility of such therapies, but their efficacy is yet to be evaluated. (NATIONAL INSTITUTES OF HEALTH LIB on November 12, 2013, http:// bloodjournal.hematologylibrary.org)
TWO OTHER PATIENTS NEARLY CURED
This year we learned that two Boston patients reported on at Conference on Retroviruses and opportunistic infections (CROI) 2013 that we hoped were ‘cured’ experienced viral rebound and needed to restart ARVs. These patients had cancer like the Berlin patient, the only known adult to be ‘cured’of HIV.
The Boston patients were given bone marrow transplants (BMTs0, but their BMT donors did not carry the delta 32 genetic mutation like the Berlin patient’s donor.
The delta 32 mutations are very rare and are thought to make one immune to HIV. Although this is bad news, we are in very early stages of cure research. We have much to learn, but every experiment adds to our knowledge, (‘Cure’ Research Highlights from the Conference On Retroviruses and Opportunistic Infections, 2014).
WHY IS AN HIV CURE FEASIBLE?
Several recent observations make scientists enthusiastic about pursuing cure research. For the first time ever there is now a ‘proof of concept’, as scientists like to call it, for an effective cure. The case of Timothy Brown, the so-called ‘Berlin Patient’, who received a stem-cell bone-marrow transplant in 2007 and is now considered to be cured of HIV, has proved that a cure is at least possible.
This stem cell transplant worked because the donor was among the one percent of Northern Europeans who lack CCR5, the ‘doorway’ through which HIV enters cells. While it is unrealistic to pursue this risky and costly therapeutic approach for most people, it has nevertheless got scientists thinking about the use of gene therapy to modify a patient’s own immune cells to make them resistant to HIV infection.
Scientists have also been aware of a rare group of HIV infected people who appear to have naturally ‘cured’ their own infection. These ‘elite controllers’ are HIV positive but have no readily apparent virus in the blood.
Scientists are gaining a better understanding of this group of patients. There exists a unique cohort of patients in France who became HIV infected, started therapy early, and were able to successfully stop therapy without viral rebound (the ‘Visconti Cohort’).
The study confirms the benefits of treating HIV at the very early stages of infection. There is an immensely valuable store of knowledge to be gained from analysing the immunological characteristics that made therapy redundant for these patients. Understanding these groups of people who efficiently control the virus replication and reservoirs, scientists believe, might lead to novel therapeutic interventions. (International AIDS Society - New HIV Cure Research Released Today at the XIX International AIDS Conference (AIDS 2012)).
http://www.times.co.sz/features/97238-are-researchers-finding-a-cure-for-hiv-aids.html
By 1983, the etiological agent, the human immunodeficiency virus (HIV), had been identified.
By the mid-1980’s, it became clear that the virus had spread, largely unnoticed, throughout most of the world, (UNAIDS, 2003). This implies that researchers have been in and out of the laboratories for three decades, searching for an HIV/AIDS cure.
The discovery of the antiretroviral drug has been a huge breakthrough. How far are we from the HIV/AIDS cure? Seemingly there’s light at the end of the tunnel. Researchers are gaining good momentum and promising results. We can’t say the cure will be available in three years time, but we can’t be shocked if it could be discovered within the next three to four years. Don’t lose hope. Hangon there! For now, just stick to your doctor’s prescriptions. Good days are just by the corner.
ONLY ONE BABY CURED OF HIV/ AIDS TO DATE
The very recent case of HIV cure in a baby flagged on March 3, 2013 is an important benchmark in HIV research. Doctors at the Johns Hopkins Children’s Centre, Mississippi, USA, announced this as a case of ‘functional cure’, meaning that the virus did not rebound even after discontinuation of the antiretroviral treatment (ART). The baby, born in Mississippi, was detected to be HIV infected by HIV DNA and RNA testing on the 2nd day of life.
She was put on ART soon after the diagnosis at about 30hrs after birth and continued until 18 months of age.
HIV plasma viral load tests for the child were positive on several occasions before reaching an undetectable level at 29 days. HIV remained undetectable at 26 months despite ART being stopped at 18 months. Although some ultrasensitive tests could detect low copies of the virus in her cells, standard clinical assays like plasma viral load, peripheral blood mononuclear cells (PBMC) DNA, and HIV-specific antibodies failed to detect traces of the virus confirming a state of ‘functional cure, (Indian J Med Res 138, December 2013, pp 824-828).
ONE ADULT HAS BEEN SUCCESSFULLY CURED OF HIV/AIDS TO DATE
The report of a single patient cured of HIV with hematopoietic stem cell (HSC) transplant has raised tremendous hope, excitement, and curiosity in the field.
The patient had HIV infection and leukaemia and was transplanted in Berlin in 2007 using HSCs from a donor whose cells lacked the functional CCR5 co-receptor required for HIV to infect cells.
Following the transplant, his antiretroviral therapy was stopped and his blood and various biopsy specimens showed no detectable HIV, suggesting that he might be cured.
However, it is not certain how functional cure was achieved with the ‘Berlin Patient’: it could be attributable to some combination of the transplant conditioning regimen, the anti–T-cell chemotherapy, graft-versus-host effect, and/or other factors in addition to the lack of a functional CCR5 co-receptor. In addition to the Berlin patient, there have been early-stage clinical studies of engineered human progenitor cells and T cells expressing anti-HIV moieties, including CCR5-inactivated T cells. These studies demonstrated the safety and feasibility of such therapies, but their efficacy is yet to be evaluated. (NATIONAL INSTITUTES OF HEALTH LIB on November 12, 2013, http:// bloodjournal.hematologylibrary.org)
TWO OTHER PATIENTS NEARLY CURED
This year we learned that two Boston patients reported on at Conference on Retroviruses and opportunistic infections (CROI) 2013 that we hoped were ‘cured’ experienced viral rebound and needed to restart ARVs. These patients had cancer like the Berlin patient, the only known adult to be ‘cured’of HIV.
The Boston patients were given bone marrow transplants (BMTs0, but their BMT donors did not carry the delta 32 genetic mutation like the Berlin patient’s donor.
The delta 32 mutations are very rare and are thought to make one immune to HIV. Although this is bad news, we are in very early stages of cure research. We have much to learn, but every experiment adds to our knowledge, (‘Cure’ Research Highlights from the Conference On Retroviruses and Opportunistic Infections, 2014).
WHY IS AN HIV CURE FEASIBLE?
Several recent observations make scientists enthusiastic about pursuing cure research. For the first time ever there is now a ‘proof of concept’, as scientists like to call it, for an effective cure. The case of Timothy Brown, the so-called ‘Berlin Patient’, who received a stem-cell bone-marrow transplant in 2007 and is now considered to be cured of HIV, has proved that a cure is at least possible.
This stem cell transplant worked because the donor was among the one percent of Northern Europeans who lack CCR5, the ‘doorway’ through which HIV enters cells. While it is unrealistic to pursue this risky and costly therapeutic approach for most people, it has nevertheless got scientists thinking about the use of gene therapy to modify a patient’s own immune cells to make them resistant to HIV infection.
Scientists have also been aware of a rare group of HIV infected people who appear to have naturally ‘cured’ their own infection. These ‘elite controllers’ are HIV positive but have no readily apparent virus in the blood.
Scientists are gaining a better understanding of this group of patients. There exists a unique cohort of patients in France who became HIV infected, started therapy early, and were able to successfully stop therapy without viral rebound (the ‘Visconti Cohort’).
The study confirms the benefits of treating HIV at the very early stages of infection. There is an immensely valuable store of knowledge to be gained from analysing the immunological characteristics that made therapy redundant for these patients. Understanding these groups of people who efficiently control the virus replication and reservoirs, scientists believe, might lead to novel therapeutic interventions. (International AIDS Society - New HIV Cure Research Released Today at the XIX International AIDS Conference (AIDS 2012)).
http://www.times.co.sz/features/97238-are-researchers-finding-a-cure-for-hiv-aids.html
