The Search for a Cure

Prof. Francoise Barré-Sinoussi and Anthony S. Fauci, MD at the 'Towards an HIV cure' 
opening session. Image ©IAS/Steve Shapiro - Commercialimage.net

The search for a cure is one of the major themes of this year’s event. Delegates at a symposium heard about the renewed efforts to find a cure and the attitudes of people with HIV to the prospect of a cure.

Towards an HIV Cure, a declaration setting out a road map of the steps needed to achieve a cure, was launched at the symposium.

Delegates heard about what scientists mean by a cure; how a cure can be achieved; and about the difficulties and challenges that lie ahead.

Renewed interest in a cure was inspired by the case of the ‘Berlin Patient’. This person was cured of HIV after undergoing a grueling course of chemotherapy, immunosuppressive treatment, and a bone marrow transplant from a donor with a rare genetic mutation making him naturally resistant to infection with HIV.

This isn’t an attractive – or realistic – therapy that can be used to cure other people with HIV. However, it showed that a cure was possible.

There’s also interest in a cure because of the ever increasing costs of treating and caring for people with HIV.

But what do scientists mean by a cure?

Delegates were told that a cure would be a therapy that either eradicated HIV from the body, or a treatment that allowed the body’s natural defenses to keep HIV in check, even after any antiretroviral therapy was stopped.

A lot more research is needed before either kind of cure is achieved.

Promising lines of research include:

• Use of HIV therapy: Doctors want to see if a prolonged period of successful HIV treatment can reduce so-called ‘reservoirs’ of cells containing latent HIV infection.

• Emptying latent reservoirs: Drugs used to treat other infections and diseases are being used to stimulate latent reservoirs, which would then be ‘purged’ by the immune system or would self-destruct. Some studies have yielded very promising results.

• A therapeutic vaccine, which would stimulate the immune system to kill activated cells.

• Gene therapy approaches, where a pool of HIV-resistant CD4 cells would be established.

There’s a consensus that these treatments will need to be used in combination.

Researchers were reluctant to commit themselves to the likely cost of finding a cure, or how long it would take. “However, now we are collaborating, it will take a considerably shorter time,” said Rowena Johnston of AmFAR.