HIV Research is at an Inflection Point, Offering Hope for a Cure | BioSpace
HIV research is at an inflection point, where a number of different approaches to attacking the virus are in or are approaching clinical development. Recent advances are giving researchers hope that a functional HIV cure or possibly even complete eradication of the virus is possible.
“Many scientific papers over the years claimed they found a cure for HIV, but none manifest a cure,” Heather Madsen, head of HIV Cure and Bioinformatics at ViiV Healthcare (the only company focused exclusively on HIV), told BioSpace. The London patient and, earlier, the Berlin patient, give us hope the virus can be eradicated.”
These people had very invasive oncology procedures in which the immune system was ablated before a bone marrow transplant. The transplanted cells were resistant to viral infection. After the transplant, HIV was undetectable in their systems.
“This is a very dangerous therapy, and some patients die,” Madsen cautioned, “but it gives a lot of hope to the field.”
Other researchers have reported they could reduce viral reservoirs which are the major barrier to a cure for HIV. That approach is based upon the finding that among some patients who were given antiviral drugs very early in the course of their disease.
“The viral reservoir of infected cells was very, very small. It was years before the virus came out of hiding,” she said. “That gives us confidence we can reach a functional cure.” Madsen defined a functional cure as one in which HIV “is undetectable for two or more years in the absence of treatment,” while noting that “the definition changes all the time.”
“There’s a lot of scientific debate about the best approach to a cure, but what’s widely agreed upon is that a cure will require a multi-pronged approach.
“The HIV virus is extremely stealthy,” Madsen continued. “It has many ways to hide from the host immune system, and to persist in the body. Within the next decade, we should have the clinical tools to test combinations of agents that effectively induce the virus out of hiding, reduce the viral reservoirs and enhance the host immune system.”
Breakthroughs in terms of longer-acting therapies are raising the bar for functional cures, Madsen acknowledged. From once-daily oral pills of modern HIV drug cocktails, the treatment field recently has advanced to interventions that can be given less frequently. ViiV Healthcare’s monthly injectable therapy, for example, recently was approved by the FDA, with an every two-month regimen currently under regulatory review.
“Several companies and academic groups are in clinical studies evaluating long-acting therapeutics that can be given once every three to six months,” she said and some groups are investigating therapeutics (including implants) that may be given only once every 12 or more months. “Those are paradigm-shifting for people living with HIV.”
The goal, though, is to eradicate the virus. “That’s very…