October 23, 2015
This week we read very promising results on using dolutegravir (Tivicay, DTG) as monotherapy. We also read about a newly designed protein that targets latently HIV-infected cells. And researchers have developed a new delivery system involving nanoformulated antiretrovirals that could offer a long-acting treatment option.
To beat HIV, you have to follow the science!
The first study followed 33 patients, and at the end of 24 weeks, 32 maintained an undetectable viral load (using a test sensitive to < 37 copies/mL). The second study followed 28 patients, and after 24 weeks, 25 maintained an undetectable viral load (using a test sensitive to < 50 copies/mL).
Dolutegravir is known for its high potency and tolerability as well as its lack of drug resistance. These results, if "supported with longer follow-up, have the potential to change HIV treatment and access globally, not least because of cost," writes Simon Collins of HIV i-Base.
Researchers at the University of Nebraska Medical Center have developed a new delivery system for antiretroviral therapy that could offer a long-acting treatment option, according to a study published in Nanomedicine: Nanotechnology, Biology and Medicine.
The researchers designed a nanoformulated protease inhibitor and placed it into a "fat and protein coat," which protects the drug from being broken down by the liver or removed by the kidneys, according to the study press release. When this nanoformulated protease inhibitor was paired with another newly designed drug known as URMC-099, the protease inhibitor's potency increased and remained active longer.
"If a drug could be given once every six months or longer that would greatly increase compliance, reduce side effects and help people manage the disease, because they won't have to think about taking medication every day," co-author Harris A. Gelbard M.D., Ph.D., said in the study press release. The preliminary results were based on laboratory experiments using human immune cells and in mice with engineered human immune systems.
Preliminary laboratory results show that a newly engineered protein can awaken and kill latent HIV, according to research at the U.S. National Institutes of Health (NIH). The new protein, called VRC07-αCD3, has the potential to target latently HIV-infected cells in humans as part of a cure strategy, but further studies are needed.
The engineered protein works by first activating latently HIV-infected cells, driving them to produce new HIV. When new pieces of virus begin to surface, the protein attaches to these pieces and brings the infected cell closer to killer T cells. Finally, the protein activates the killer T cell to destroy the reactivated HIV.
The researchers are moving on to study the protein's effectiveness in animal models.
In 2009, results from the RV144 trial, also known as the Thai trial, showed the first signs of an effective HIV vaccine, with a modest 31% reduction in HIV among vaccinated participants. Now an analysis of the study data is providing clues into the correlates of protection, or the mechanisms behind and reasons why those people were protected against infection.
The analysis found that many of the vaccinees produced antibodies in the immunoglobulin G (IgG) family, which bind to the HIV envelope, and these antibodies were associated with HIV protection, according to the study press release. However, high levels of antibodies in the immunoglobulin A (IgA) family were associated with a lack of protection, with data suggesting IgA counteracts IgG.
Is there a development this week in HIV research that you think we missed? Send us a tip!
Warren Tong is the senior science editor for TheBody.com and TheBodyPRO.com.
Follow Warren on Twitter: @WarrenAtTheBody.
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