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Back to Section One | Back to Arts & Entertainment
posted Friday, August 3 2012 - Volume 40 Issue 31
Researchers see hopeful signs for AIDS cure at DC conference
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Researchers see hopeful signs for AIDS cure at DC conference

by Mike Andrew - SGN Staff Writer

Two studies announced at the International AIDS Conference in Washington, D.C., have opened new possibilities in the search for a cure for HIV/AIDS.

On July 25, scientists said they had used a drug normally prescribed for cancer to flush out dormant HIV from trial patients' white blood cells. The next day, another group of researchers announced that two HIV-positive patients showed no trace of HIV in their lymphocytes following bone marrow transplants.

In a study published in the scientific journal Nature, researchers reported using the chemotherapy drug vorinostat to revive - and therefore identify - dormant HIV in the CD4+ T cells of eight trial patients.

The patients were also prescribed antiretroviral drugs, which stop HIV from multiplying but have to be taken for life because they do not kill the virus hidden away in reservoirs.

'After a single dose of the [anti-cancer] drug, at least for a moment in time, [vorinostat] is flushing the virus out of hiding,' study co-author Dr. David Margolis of the University of North Carolina told the news agency AFP at the conference.

'This is proof of the concept, of the idea that the virus can be specifically targeted in a patient by a drug, and essentially opens up the way for this class of drugs to be studied for use in this way.'

Vorinostat targets an enzyme that allows the virus to lie latent in patients' cells. Exactly what would happen after the virus was revealed in reservoir cells is not certain, Margolis said.

'We know that many cells that produce HIV die in the process. We know many cells that produce HIV can be identified and killed by the immune system. As far as we can tell, all the viruses floating around while patients are taking therapy don't get into cells because they are blocked by the therapy,' Margolis said.

Without a host cell, he said, HIV would die within a few minutes.

Researchers also cautioned that vorinostat may have some toxic effects and stressed that their study was merely an early indication of feasibility that had to be explored further.

'There is a possibility that this could work,' said Margolis. 'But ... if it is only 99 percent true and one percent of the virus escapes, it won't succeed. That is why we have to be careful about our work and what we claim about it.'

MARROW TRANSPLANTS HOLD PROMISE
In the second study discussed at the AIDS conference, a team of researchers at Harvard Medical School found that a combination of bone marrow transplants and antiretroviral therapy appeared to eliminate HIV from their patients' blood.

HIV patients on antiretroviral therapy often achieve 'undetectable viral loads,' meaning there are no virus particles in their blood. But they still have dormant HIV in their lymphocytes - a type of white blood cell that plays a key role in the body's immune system. If antiretroviral therapy is interrupted, the dormant HIV can reactivate.

According to researchers, eliminating traces of HIV in these cells is an indication that the 'reservoir' of latent HIV may also have been eliminated.

'We believe the transplanted cells killed off and replaced all of the patients' own lymphocytes, including the infected cells, and the donor cells were protected from becoming infected themselves by the antiretroviral therapy [the patients] were taking throughout the transplant period,' said study senior author Dr. Daniel Kuritzkes, chief of infectious diseases at Brigham and Women's Hospital, and professor of medicine at Harvard Medical School.

The 'next logical step,' Kuritzkes said, would be to take the patients off their medication regimens to verify that transplant therapy can eradicate HIV. That would require patient consent and adherence to ethics protocols, he added.

But even if the transplant procedure were found to eliminate the reservoir of latent HIV cells, bone marrow transplantation is a very risky procedure. Kuritzkes said he does not 'foresee bone marrow transplantation being performed on otherwise healthy HIV-infected patients who are doing well on [antiretroviral therapy].'

Other medical experts said the two studies were promising because of their apparent success in eliminating the patients' reservoirs of dormant HIV.

'Eliminating the reservoir is the key to the cure,' said Dr. Savita Pahwa, director of the Center for AIDS Research at University of Miami's Miller School of Medicine.

She also stressed that it would only be possible to say these patients were 'functionally cured' if the virus did not rebound when the patients went off antiretroviral therapy.

'Every hint you get that it's possible to wipe out the reservoir needs to be investigated,' Pahwa added.

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