Danish scientists are expecting results that will show that “finding a
mass-distributable and affordable cure to HIV is possible”.
They are
conducting clinical trials to test a “novel strategy” in which the HIV
virus is stripped from human DNA and destroyed permanently by the immune
system.
The move would represent a dramatic step forward in the attempt to find a cure for the virus, which causes Aids.
The
scientists are currently conducting human trials on their treatment, in
the hope of proving that it is effective. It has already been found to
work in laboratory tests.
The technique involves releasing the HIV
virus from “reservoirs” it forms in DNA cells, bringing it to the
surface of the cells. Once it comes to the surface, the body’s natural
immune system can kill the virus through being boosted by a “vaccine”.
In
vitro studies — those that use human cells in a laboratory — of the new
technique proved so successful that in January, the Danish Research
Council awarded the team 12 million Danish kroner (£1.5 million) to
pursue their findings in clinical trials with human subjects.
These are now under way, and according to Dr Søgaard, the early signs are “promising”.
Dr
Ole Søgaard, a senior researcher at the Aarhus University Hospital in
Denmark who is part of the research team, said: “I am almost certain
that we will be successful in releasing the reservoirs of HIV.
“The
challenge will be getting the patients’ immune system to recognise the
virus and destroy it. This depends on the strength and sensitivity of
individual immune systems.”
Fifteen patients are currently taking
part in the trials, and if they are found to have successfully been
cured of HIV, the “cure” will be tested on a wider scale.
Dr Søgaard
stressed that a cure is not the same as a preventative vaccine, and that
raising awareness of unsafe behaviour, including unprotected sex and
sharing needles, remains of paramount importance in combating HIV.
With modern HIV treatment, a patient can live an almost normal life, even into old age, with limited side effects.
However,
if medication is stopped, HIV reservoirs become active and start to
produce more of the virus, meaning that symptoms can reappear within two
weeks.
Finding a cure would free a patient from the need to take
continuous HIV medication, and save health services billions of pounds.
The
technique is being researched in Britain, but studies have not yet
moved on to the clinical trial stage. Five universities — Oxford,
Cambridge, Imperial College, London, University College, London and
King’s College, London — have jointly formed the Collaborative HIV
Eradication of Reservoirs UK Biomedical Research Centre group (CHERUB),
which is dedicated to finding an HIV cure.
They have applied to the
Medical Research Council for funding to conduct clinical trials, which
will seek to combine techniques to release the reservoirs of HIV with
immunotherapy to destroy the virus.
In addition, they are focusing on
patients that have only recently been infected, as they believe this
will improve chances of a cure. The group hopes to receive a funding
decision in May.
“When the first patient is cured in this way it will
be a spectacular moment,” says Dr John Frater, a clinical research
fellow at the Nuffield School of Medicine, Oxford University, and a
member of the CHERUB group.
“It will prove that we are heading in the
right direction and demonstrate that a cure is possible. But I think it
will be five years before we see a cure that can be offered on a large
scale.”
The Danish team’s research is among the most advanced and
fast moving in the world, as that they have streamlined the process of
putting the latest basic science discoveries into clinical testing.
This
means that researchers can progress more quickly to clinical trials,
accelerating the process and reaching reliable results sooner than many
others.
The technique uses drugs called HDAC Inhibitors, which are
more commonly used in treating cancer, to drive out the HIV from a
patient’s DNA. The Danish researchers are using a particularly powerful
type of HDAC inhibitor called Panobinostat.
Five years ago, the
general consensus was that HIV could not be cured. But then Timothy Ray
Brown, an HIV sufferer — who has become known in the field as the Berlin
Patient — developed leukaemia.
He had a bone marrow transplant from a
donor with a rare genetic mutation that made his cells resistant to
HIV. As a result, in 2007 Mr Brown became the first man to ever be fully
cured of the disease.
Replicating this procedure on a mass scale is
impossible. Nevertheless, the Brown case caused a sea change in
research, with scientists focusing on finding a cure as well as
suppressing the symptoms.
Two principal approaches are currently
being pursued. The first, gene therapy, aims to make a patient’s immune
system resistant to HIV. This is complex and expensive, and not easily
transferrable to diverse gene pools around the world.
The second
approach is the one being pursued by Dr Søgaard and his colleagues in
Denmark, the CHERUB group in Britain, and by other laboratories in the
United States and Europe.
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