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Another step toward an HIV cure
Researchers at the University of North Carolina Chapel Hill (UNC) have shown that HIV can be coaxed of out hiding in a person's body so that it could, theoretically, be more effectively attacked and perhaps eradicated.
The idea is to encourage production of the dormant AIDS-causing virus in patients in a safe way so that it can be detected and attacked by the immune system. The UNC researchers, using the Merck drug Zolinza (vorinostat, which is for treating cutaneous T-cell lymphoma), showed that they could coax the virus out from inside certain immune-system cells, where it typically evades drugs meant to fight AIDS.
The finding were announced at the recent 19th annual Conference on Retroviruses and Opportunistic Infections in Seattle, Wash., but there are, of course, caveats. For one thing, the study involved six men with HIV infection, meaning it's a small and pretty homogenous group. Also, other studies released at the same event in Seattle suggest that merely getting HIV to come out of hiding isn't enough for the body to be able to kill them.
Still, it is a start to fighting a virus that is very good at evading the body's immune defenses.
None of the patients were cured in the trial, but the researchers (led by Dr. David Margolis) hope that Zolinza or similar drugs may be able to help purge HIV from patients' bodies. Margolis told Bloomberg he expects to hear soon from the U.S. Food and Drug Administration for approval for an additional test using more doses of Zolinza.
"What people want to know is when can someone go to a doctor and be handed a pill and be cured," Margolis told Bloomberg. "That's decades away. Think of it more in terms of curing cancer. I think in 10 years someone with HIV infection could go to a specialist and get a complicated treatment and have some likelihood of a prolonged remission of their HIV."
As noted by the journal Nature, previous studies had suggested that suberoylanilide hydroxamic acid (SAHA)—a class of which Zolinza/vorinostat is a part—could "push the virus out of its slumber, but the approach had not been tested in people." That's where Margolis, a molecular virologist, and his UNC team came in, treating six people with a single dose of SAHA and testing its effect on CD4+ T cells — immune cells that are targeted for infection by HIV.
As Nature notes, the study found that SAHA did kick-start transcription of HIV in latently infected CD4+ T cells; researchers detected nearly five times as many HIV transcripts in the patients' resting CD4+ T cells after treatment as before. There were no serious side effects.
"This study provides the first proof-of-concept demonstration of disruption of latency, which is a significant step towards eradication" of HIV from the body, said Margolis of the results.