New breakthrough brings researchers closer to a "functional cure" for HIV

An HIV expert at the University of California, San Francisco, presented evidence this week of a major advance in the search for a “functional cure” for HIV infection

“It is inspiration and a potential road map to get to where we need to go,” said Dr. Steve Deeks, who leads a team of researchers at Caring Cross, a nonprofit focused on developing broadly available immunotherapies.

Deeks presented the group’s findings at a gene therapy conference in Boston on Tuesday.

After a single infusion of immune cells engineered to recognize HIV, the virus in two study participants was suppressed to undetectable levels. Suppression has lasted nearly two years for one of the patients, The New York Times reports.

Based on technology already developed to attack cancer cells, the scientists at Caring Cross engineered immune cells from each study participant to carry two molecules on the immune cells’ surface. Both bind to HIV and kill infected cells, but one also prevents the immune cells from becoming infected.

“It’s this dual nature of targeting — killing and protecting — that we think is the missing piece in terms of how this therapy works,” Dr. Boro Dropulić, executive director of Caring Cross, told The Times.

After extracting and modifying each patient’s immune cells, researchers injected them back in, in a process called infusion.

HIV positive individuals who stop taking antiretroviral drugs (ARVs) will typically see the virus roar back within two weeks. But two of the study participants have remained undetectable after 92 and 48 weeks, respectively, after infusion and simultaneously stopping antiretroviral therapy.

A third participant partially suppressed the virus for 12 weeks before rebounding.

All three participants had started antiretroviral therapy shortly after infection, a key finding versus others in the study who lived longer with HIV before taking ARVs, and who didn’t respond as well to the modified immune cell therapy.

Researchers say that might be because HIV hides deep in the body where it evades both the immune system and drugs designed to track it down; the longer an individual harbors HIV without the suppressing effects of ARV therapy, the longer it has a chance to replicate and build up in those deep recesses.

“Three out of three people with early disease doing some degree of control, to me, is the most provocative finding here,” Dr. Deeks said.

“This work represents the culmination of years of scientific and clinical effort to develop a therapy that harnesses the body’s own immune cells to fight HIV,” Dr. Dropulić said in a statement from the group. He called it an important step toward “a definitive therapeutic solution.”

“We have already advanced next-generation versions that we expect will further enhance the potency and durability of the anti-HIV response, bringing us closer to a lasting, potentially one-time treatment.”

Scientists envision a single shot that one day will keep HIV at undetectable levels for a lifetime, a “functional cure” that takes into account HIV’s still unexplained ability to linger deep in the body, however healthy an individual may be.

Remarkable strides in treatment have already been made over the last several years, keeping the virus at bay with ARVs in daily pill form and monthly or bi-monthly injections, along with longer-acting options in the pipeline, including weekly and monthly pills, and shots that could be given just once a year.

On the prevention side, use of PrEP has grown to more than 3.5 million people worldwide, according to the National Institutes of Health.

An affordable “one-time treatment” for the virus would all but spell the end of the HIV epidemic, eliminating the potential interruptions in sustained treatment for at-risk populations seen in the current administration’s dismantling of PEPFAR worldwide, and the loss of health insurance coverage and access from Medicaid cuts in the U.S.

Caring Cross estimates 1.3 million new HIV infections occur each year, more than 700,000 people die annually from HIV-related causes, and more than 40 million people are living with HIV worldwide.

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Originally published here.