HIV WAR­RIORS

1 500 women put their bod­ies on the line

Sunday Times - - FRONT PAGE - By CLAIRE KEE­TON

A young woman curled up un­der a yel­low blan­ket in a Cape Town hos­pi­tal ward is calm as a drip pumps fluid into her body.

This 22-year-old and 1 499 other women might emerge as he­roes who used their bod­ies to help pro­tect the lives of mil­lions around the world.

She is a vol­un­teer in an in­ter­na­tional trial to test a revo­lu­tion­ary way to pre­vent HIV in­fec­tion. The AMP (an­ti­body me­di­ated pro­tec­tion) study will test whether an­ti­bod­ies pro­vide pro­tec­tion against HIV.

The an­ti­bod­ies — man­u­fac­tured from peo­ple who have po­tent nat­u­ral re­sis­tance to HIV — are ex­pected to im­me­di­ately boost the woman’s im­mune sys­tem and re­duce her risk of in­fec­tion.

Dr Catherine Or­rell, the AMP prin­ci­pal in­ves­ti­ga­tor at Groote Schuur Hos­pi­tal, said: “In­stead of ask­ing the body to make an­ti­bod­ies, we are giv­ing them an­ti­bod­ies. We do our best to pre­vent HIV through ed­u­ca­tion, treat­ing STIs [sex­u­ally-trans­mit­ted in­fec­tions] and en­cour­ag­ing women to use con­doms, but some women are ex­posed to risk de­spite all that. That’s when we hope the an­ti­bod­ies will step in.”

Women like 24-year-old Sihle Koba, the first vol­un­teer to get an in­fu­sion in this ward, are flock­ing to join the study which is re­cruit­ing HIV-neg­a­tive women aged 18 to 40. Koba re­ceived her first in­fu­sion in July 2016.

She said: “I’m ex­cited and want to make a change in the world. Too many peo­ple in my fam­ily have got in­fec­tions.”

The vol­un­teers come to the clin­i­cal trial ward every eight weeks to get the an­ti­body in­fu­sions, and every al­ter­nate month for check-ups. None has had neg­a­tive side ef­fects so far.

Or­rell said giv­ing healthy peo­ple an IV drip was not prac­ti­cal for mass preven­tion. Down the line a prod­uct could be de­vel­oped al­low­ing peo­ple to give them­selves a shot un­der the skin a few times a year.

Pro­fes­sor Lynn Mor­ris, head of HIV vi­rol­ogy at the Na­tional In­sti­tute for Com­mu­ni­ca­ble Dis­eases, pre­sented an over­view of the AMP study at the con­fer­ence of the South African Im­munol­ogy So­ci­ety in Gor­don’s Bay last week.

The lab Mor­ris runs is test­ing blood from the AMP vol­un­teers who be­come in­fected dur­ing the trial to see if their viruses are nat­u­rally re­sis­tant to the an­ti­bod­ies.

Like the vol­un­teers and doc­tors in­volved, no sci­en­tists in the lab know which bloods come from the women who re­ceive a low dose of the an­ti­body, a higher dose, or an in­fu­sion of placebo.

This VRC01 an­ti­body is a first-gen­er­a­tion prod­uct and pro­vides pro­tec­tion against most types of virus, but even more po­tent and longer-last­ing ones have since been found. An an­ti­body called CAP256-VRC26, dis­cov­ered in the blood of a South African woman, is roughly 100 times more pow­er­ful than VRC01. It is be­ing man­u­fac­tured in the US for vol­un­teers in South Africa once it has passed ini­tial safety and ef­fi­cacy tri­als.

“The an­ti­body is be­ing made in big, steel vats and it looks like a brew­ery,” said Mor­ris, adding that ther­a­peu­tic an­ti­bod­ies were a ma­jor growth in­dus­try.

Pre­vi­ously, an­ti­bod­ies were used mostly for cancer treat­ment but now they are be­ing made against viruses like ra­bies, Ebola and flu — and could in fu­ture be­come a pow­er­ful weapon against HIV.

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