MONDAY, JUNE 18, 2018

Research team makes promising discovery for HIV treatment

Immune systems manage bursts of HIV activity
Immune systems manage bursts of HIV activity | Courtesy of
A team of researchers has discovered that the human immune system can manage large bursts of activity of HIV, suggesting that it may be possible to use a “kick and kill” strategy to treat and cure HIV.

The research, led by the University of North Carolina at Chapel Hill (UCL) and the University of Oxford, suggests that using a vaccine will stimulate the immune system and awaken dormant HIV infections living within white blood cells. The “kick” of the vaccine could help the immune system identify the hiding HIV and kill the virus cells.

"Our study shows that the immune system can be as powerful as the most potent combination drug cocktails," UCL Infection & Immunity Professor Dr. Ravi Gupta, co-author of the study, said. "We're still a long way from being able to cure HIV patients, as we still need to develop and test effective vaccines, but this study takes us one step closer by showing us what type of immune responses an effective vaccine should induce."

Previously, this theory could not clearly answer whether the immune system could fully manage a full-blown HIV reactivation. This latest research uses a single patient case study to prove that it is possible.

"By measuring the strength of the immune system required to keep this virus under control in this rare individual, we have a better idea of the requirements for successful future treatment," UCL Infection & Immunity Professor Deenan Pillay, co-author of the study, said. "We also managed to identify the specific immune cells that fought the infection. This is a single patient study, but nevertheless it is often the unusual patients who help us to understand the HIV disease process."

The case study involved a 59-year-old man residing in London. He had both HIV and myeloma (bone marrow cancer). Researchers labeled him an “elite controller” because his immune system was able to manage HIV for long periods of time without receiving any treatment. Only 0.3 percent of HIV patients are elite controllers, and even they require treatments to avoid HIV progressing to AIDS.

"We need to be cautious in interpreting observations from a single subject," Dr Nilu Goonetilleke, who began working on the study at the University of Oxford and is now at the University of North Carolina at Chapel Hill, said. "However, demonstration, even from a single subject, that our immune system can rapidly control HIV-1 tells us a lot about the types of immune responses we should target and augment through vaccination."

The man’s cancer treatments reawakened HIV, but after two weeks of high blood counts of HIV, the HIV levels fell suddenly and rapidly; his body’s natural immune system was able to decrease the levels of HIV at rates similar to those induced by the most powerful treatments on the market.

“Drugs to stimulate reactivation of dormant HIV are still imperfect, and we do not know if they would be able to flush out all of the HIV from the body,” Gupta said. “Likewise, it remains to be seen whether a vaccine could enable a normal HIV patient's immune system to kill HIV with the full strength of an elite controller. Our study is a proof of principle, and the results are promising, but it is unlikely to lead to a cure for at least a decade."

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University of North Carolina-Chapel Hill

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