HIV: First ever HIV immunotherapy drug shows promise

Ateam of researchers at the University of North Carolina at Chapel Hill have proven that it is safe to use an immunotherapy drug in treatment in HIV.

The phase 1 trial is an early but significant milestone for the team hoping to cure HIV. For the first time, in a study published by the journal Cell Reports, the North Carolina team has confirmed their hopes: that immunotherapy could be administered to HIV positive patients without a realistic risk of death - and many are tipping it as proof that this could be it.

They won a grant of $4m a year for 5 years from GlaxoSmithKline in a bid to arrive at the first HIV cure.

Immunotherapy trains a person’s immune system to attack a disease, and is now being used to treat several conditions such as blindness, and cancer.

Scientists however tread with care when it comes to HIV, because attempts in the last 20 years to cure the virus with bone marrow transplants (another mainstream treatment which replaces a person’s immune system with that of a donor) have proved fatal in all but one person, said MailOnline.

Dr David Margolis, co-senior author of the new paper said they think that they will be able to replicate the results of the Berlin patient (the only person ever cured of HIV), “but that will take a while, on a step-bystep trajectory,” said Dr Margolis,

Dr Margolis, his co-senior author Catherine Bollard of the Children’s National Health System, hope to achieve HIV cure with immunotherapy.

The phase 1 trial is the first to be published. The aim was to prove that the immune system could be trained to attack HIV, without sparking an internal civil war between cells that could kill the patient in the process.

It was a small study, testing the method on six patients. It involved extracting T cells (a lymphocyte crucial to the immune system), growing them in the lab so they multiply, then injecting them back in so they can go into overdrive attacking the virus inside.

All of the patients in this study had been on ART for an average of six years. They didn’t see any significant benefits, but that wasn’t the point. The point was to check that it didn’t hurt anyone.

Ultimately, the plan is to first administer a therapy that would bring out the HIV from hiding, before unleashing the T cells.

The method has been dubbed the ‘shock and kill’ technique.

“This is a promising advancement for the field,’ says first author Julia Sung of UNC, although she also cautions people against overinterpreting the results. “The study did not cure HIV and should not be interpreted as doing so, but we also are very encouraged by the safety data, so it should not be considered discouraging either. This paves the way for the next step,” she said.

The only person ever cured of HIV is an American man called Timothy Brown, widely known as ‘the Berlin patient’ because he was cured in Berlin in 2007.

Brown already had HIV when he was diagnosed with leukemia, a disease of the bone marrow which can be treated with a bone marrow transplant. Not only did Brown survive the operation, and survived free of leukemia, he also had no trace of the human immunodeficiency virus.

These days, HIV positive patients are prescribed anti-retroviral therapy (ART), which is now so effective that it can suppress the virus within six months - to such an extent that it is deemed undetectable and untransmittable. (It is important to note that becoming undetectable requires the person to take the drug consistently, and staying undetectable requires keeping up their regimen).

ART, and PrEP (pre-exposure prophylaxis, a pill which protects a person from contracting HIV), have been game changers in the fight against HIV/AIDS, drastically cutting the rate of new infections, and turning HIV from a death sentence to a life-long chronic illness.

However, the one thing that no one can get at is the elusive phenomenon of latent HIV: strands of the virus which lie hidden and dormant in ‘reservoirs’ of the body, evading treatment.