British scientists on brink of HIV Cure! vol 5 rel 13

The World Health Organization estimates that around 35 million people in the world are living with HIV. The virus is more common in many sub-Saharan African countries.

A British man could become the first person in the world to be cured of HIV using a new therapy[1] designed by a team of scientists from five UK universities. Scientists told The Sunday Times that presently the virus is completely undetectable in the man’s blood.

The 44-year-old is one of 50 people currently trialing a treatment which targets the disease even in its dormant state.

Scientists said that the virus is completely undetectable in the man’s blood, although that could be a result of regular drugs. However if the dormant cells are also cleared out it could represent the first complete cure.

Current treatments, called anti-retroviral therapies (Art), target that process but they cannot spot dormant infected T-cells.  

The new therapy works in two stages. First, like many traditional therapies, a vaccine helps the body recognize the HIV-infected cells so it can clear them out. However, the second stage is really the leap forward, a new drug called Vorinostat activates the dormant T-cells so they can be spotted by the immune system.

What is Vorinostat?

Other Names: MK-0683, VOR, Zolinza, suberoylanilide hydroxamic acid (SAHA)

Drug Class: Latency-Reversing Agents

Molecular Formula: C₁₄ H₂₀ N₂ O₃

Registry Number: 149647-78-9 (CAS)

Chemical Name: 8-(hydroxyamino)-8-oxo-N-phenyl-octanamide

Chemical Class: Other Carboxylic Acid Derivatives

Company: Merck & Co., Inc.

Phase of Development: II

Vorinostat (brand name: Zolinza) is a drug that has been approved by FDA for the treatment of cancer and is currently being studied as part of a possible strategy to cure HIV infection.^4-8

Currently, there is no cure for HIV infection. One of the main obstacles to curing HIV infection is that the virus can remain hidden and inactive (latent) inside certain cells of the immune system (such as resting CD4 T cells) for many months or even years. While HIV is in this latent state, the immune system cannot recognize the virus, and antiretroviral therapy (ART) has no effect on it. (ART is the recommended treatment for HIV infection and involves using a combination of different antiretroviral [ARV] drugs to prevent HIV from replicating.)

Vorinostat belongs to a general class (group) of HIV drugs called latency-reversing agents.³ Latency-reversing agents reactivate (turn back on) latent HIV within resting CD4 T cells.^10,11 There are different types of latency-reversing agents. Vorinostat is a type of latency-reversing agent called a histone deacetylase (HDAC) inhibitor.¹¹

How do latency-reversing agents work?

Latency-reversing agents reactivate (turn back on) latent HIV within resting CD4 T cells. When latent HIV is reactivated, it is once again able to produce new virus and multiply (replicate). It is hoped that after latent HIV is reactivated, the CD4 T cells in which the virus was hiding are more likely to die off on their own or be recognized and killed by the body’s immune system.^10,11

In addition, any new virus that is produced during reactivation can then be prevented from infecting other cells with the use of ongoing ART.^10,11 Recent research has shown that additional therapies, together with latency-reversing agents, may be needed to fully eliminate latent HIV from the body

How is the Patient?

The first unidentified patient, a social care worker in London, said: "It would be great if a cure has happened. My last blood test was a couple of weeks ago and there is no detectable virus.

"I took part in the trial to help others as well as myself. It would be a massive achievement if, after all these years, something is found to cure people of this disease. The fact that I was a part of that would be incredible."

How the Pro’s View This?

Professor Sarah Fidler, a consultant physician at Imperial College London, added: "This therapy is specifically designed to clear the body of all HIV viruses, including dormant ones.

"It has worked in the laboratory and there is good evidence it will work in humans too, but we must stress we are still a long way from any actual therapy.

"We will continue with medical tests for the next five years and at the moment we are not recommending stopping Art but in the future depending on the test results we may explore this."

Philip Christopher Baldwin, an HIV awareness activist. "I'm really excited by the recent developments regarding a potential cure for the HIV virus.

"The first person to complete an experimental course of treatment has cleared the virus. I was diagnosed with HIV in 2010, when I was 24 years old. It took me a number of years to come to terms with my HIV.

"I am proud that five British universities have been responsible for this pioneering research. It remains to be seen whether the virus will return in the "cured" patient, or if the other people taking part in the medical trial will respond in a similar way.

"The research, though, is great progress and I hope that these early results will be repeated throughout the trial group. This is an important step towards a world free of the fear of HIV."

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Source(s)

• https://aidsinfo.nih.gov/drugs/529/vorinostat/0/patient#
• http://www.nhs.uk/conditions/HIV/Pages/Introduction.aspx
• http://www.thetimes.co.uk/article/british-scientists-on-brink-of-hiv-cure-w7zb86zw0

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[1] The distinction here is by a therapy, for the first person has ever been cured of HIV received a stem cell transplant from a patient with natural immunity to HIV in 2008.