For more than three decades, the world has been dealing with the Human Immunodeficiency Virus, better known as HIV. Current statistics show that more than 38 million people have active HIV infections. Also, since the 1980s, more than 36 million have died as a result of AIDS and its complications. Today, there are new HIV treatments that can be used to keep the virus in check. However, an actual cure for HIV remains elusive due to the inherent nature of the virus’ behavior. But based on recent research, this may soon change in the near future as scientists discover new insights.
In the last few years, researchers have revealed additional clues concerning how the HIV virus escapes eradication. While new HIV treatments are effective in preventing the virus from replicating, these do little to rid the body of it. For this reason, different strategies are needed if scientists hope to find a cure for HIV. Fortunately, the most recent investigations suggest precisely the type of approach that might be required. And if newer agents can be developed in this regard, there is significant reason for optimism. Despite being years away, we may be seeing the beginning of the end when it comes to HIV.
“Increasing evidence suggests that durable drug-free control of HIV-1 replication is enabled by effective cellular immune responses.” – Dr. Xiaodong Lian, Post-doctoral Research Fellow, Ragon Institute of MGH, MIT and Harvard
Understanding HIV’s Unique Behaviors
In regards to causing infection, HIV is a retrovirus that specifically targets and infect immune cells in the body. If untreated, these immune cells gradually decline and die, resulting in increasing susceptibility to infections and cancers. In the last couple of decades, however, anti-retroviral therapies (ART) have been developed. These new HIV treatments prevent the HIV virus from spreading and from being active. But this is only one piece of the puzzle. It’s also a reason ART drugs do not represent a cure for HIV.
The issue with the HIV virus is that it persists in a dormant state within the cells it infects. While ART drugs keep it in check, it is unable to eradicate it from these cells. In fact, the HIV virus hides itself within immune cells’ chromosomes and waits for an opportunity to return. Therefore, when patients stop taking their ART drugs, the HIV becomes active all over again. Finding new HIV treatments that address this unique feature of HIV has been frustrating for researchers. But new approaches suggest that a cure for HIV may be in sight. This is because new HIV treatments that seek out these latent HIV viruses may soon be around the corner.
The Success of “Kick and Kill” Strategies
Understanding that HIV can lie dormant in a person’s body, scientists have long realized virus reactivation might be required. In order for a person’s immune system or medication to destroy the virus, it must be brought out into the open. Only then will it be possible to eliminate all HIV viral particles in the body. Therefore, investigations into new HIV treatments have recently been exploring what is known as a “kick and kill” approach. One drug “kicks” the latent virus out of hiding into an activated state. Then, another drug “kills” it permanently, hopefully eradicating it completely. If such an approach is comprehensive, then it would offer a cure for HIV once and for all. This is the area where current research investigations have invested their efforts as of late.
The most recent research in this regard was conducted at UCLA. In the study, scientists administered a combination “kick and kill” therapy to mice with HIV currently on ART. One drug, which was named SUW133, forced latent HIV viruses our of hiding. Then, the second treatment involved administration of mouse Natural Killer immune cells that destroyed the HIV virus. The results of their investigation found that 40% of the mice no longer harbored any HIV virus cells at all. Thus, they concluded that these types of new HIV treatments could indeed offer an eventual cure for HIV.
“These findings show proof-of-concept for a therapeutic strategy to potentially eliminate HIV from the body, a task that had been nearly insurmountable for many years,” The study opens a new paradigm for a possible HIV cure in the future.” – Jocelyn Kim, Assistant Clinical Professor in Health Sciences, UCLA
Proactive Versus Retroactive Treatments
With millions of individuals actively infected with HIV, a cure for HIV is naturally important. New HIV treatments that can further refine a kick and kill approach in humans will be needed regardless. But as is usually the case, prevention remains the best and most cost-effective strategy. In this regard, such HIV prevention therapies already exist, including HIV vaccines. Other agents can be taken on a regular basis to prevent infection, and still others can be taken shortly after a potential exposure. And still others can be taken by HIV infected individuals to prevent further spread. These therapies are called PreP, PeP and TasP, respectively.
PreP stands for Pre-exposure Prophylaxis while PeP is an acronym for Post-exposure Prophylaxis. TasP is short for Treatment as Prevention. Of these options, PreP is the most effective, preventing 99% of sexually transmitted HIV infections. Each of these new HIV treatments are designed for those at high-risk for acquiring HIV. But despite their efficacy and FDA-approved status, fewer than a quarter of at-risk individuals use them. HIV stigma, cost, lack of insurance coverage, and poor access to information account for this low rate of use. At the same time, these statistics show why a cure for HIV remains an important long-term goal.
Hope for an HIV-Free Future
The current research described notably involve mice infected with HIV. Therefore, the safety and effectiveness of these kick and kill therapies has only been assessed in animal research. Likewise, while this looked to be a cure for HIV in 40 percent of the mice, 60 percent had an incomplete response. All of this implies that additional research is needed before these types of new HIV treatments will be available. Regardless, these findings offer hope that a cure for HIV may not be too far away. And for millions of people who actively have the disease, this is great news.