Press Conference: Toward the Cure

"Today might be considered the day when the cure research agenda moves from the lab into the clinic."

This statement, from Stephen Deeks, M.D., set the stage for the press conference in which a panel of scientists presented new breakthroughs in research for an HIV cure. Three important breakthroughs were announced:

• Bone marrow transplants that appear to have eradicated HIV without using HIV resistant T cells
• A drug that reaches latent HIV cells
• A possible functional cure from early ART for a small segment of people

Dan Kuritzkes, M.D., Harvard Medical School, described his research team's study of HIV in two HIV-positive gay men with leukemia who received stem cell transplants. Both had been on ART and had suppressed viral loads, but detectable latent virus. They received mild chemotherapy before the transplant which allowed them to remain on ART during the transplant period. After the transplant, the amount of HIV DNA in blood cells decreased and became undetectable. After more than two years, no trace of HIV can be found in their blood plasma. Unlike the "Berlin Patient," the stem cells these men received carry CCR5 receptors and are susceptible to HIV infection. The research team believes that continuous HIV therapy allowed new cells to not become infected and gradually replace infected cells. This means that it is possible to protect uninfected cells from becoming infected when transferred in HIV-positive person.

David Margolis, M.D., University of North Carolina, Chapel Hill, discussed results of clinical trials attempting to eradicate HIV from the bodies of HIV-positive people. One major challenge to eradication is the ability of HIV to hide in reservoirs within the body. In the clinical trials, people living with HIV and taking ART were given a single dose of Virinostat, a histone deacetylase inhibitor used in cancer treatment. During the time of exposure to Virinostat in their blood, the hidden HIV cells were forced out into the open where they are vulnerable to ART. Margolis explained that this approach may turn the situation into one in which HIV has to constantly find new cells to infect or be extinguished, at which point we can eradicate it.

Asier Saez-Cirion, Ph.D., from the French National Agency for Research on AIDS and Viral Hepatitis, announced results of a retrospective examination of patients who have been able to control HIV on their own. They studied 14 people living with HIV in France who were treated immediately after infection (on average, 40 days after infection), who stayed on ART for a minimum of three years, and who have since controlled HIV without therapy for seven years or longer. These individuals lack the characteristics and response to infection of natural HIV controllers, leading the researchers to believe that the ability to control HIV resulted from early ART initiation.

A misleading press release was distributed relating to this research, claiming that this study "confirms the benefits of treating HIV at the very early stages of infection." Yet in the press conference, Saez-Cirion indicated that this outcome seems to be possible only for 5% to 15% of people. Before such claims about the benefits of early treatment can be made, the effects on the remaining 85% to 95% of people with HIV need investigation.

Closing the press conference, Francoise Barre-Sinouse described efforts spearheaded by the International AIDS Society to connect, mobilize, stimulate, and promote research, thus accelerating research on an HIV cure.

Written by Laurel Sprague for the Community Track Rapporteur Team, XIX International AIDS Conference.