On the way for a society without AIDS, progress has been achieved in developing new strategies for HIV reservoirs functional control. Hope for a drug-free HIV remission is now on the horizon.
Toulon, France, January 03, 2011 — On the way for a society without AIDS, progress has been achieved in developing new strategies for HIV reservoirs functional control. Hope for a drug-free HIV remission is now on the horizon.
Finding a cure for HIV infection requires stopping ongoing viral replication, identifying all HIV reservoirs in which non-replicating latent HIV persists and eradicating or controlling them without the need of continued antiretroviral therapy. Advances have recently been made in each of these areas and the word cure is no longer a forbidden term.
New HIV latency models
New cell models of HIV latency have been established, allowing a better characterization of the mechanisms of HIV persistence, as the selection of chemical compounds able to wake-up HIV from its latent state.
New drugs in the pipeline
The goal is to flush out and kill latent viruses in HIV reservoirs that remain in the body even when viral load is undetectable. Until now, no one could figure out how to activate only cells latently infected with HIV, and not all inactive cells, which could be deadly. Using the new intro models, a Baltimore team was able to screen 9 compounds doing exactly what needed. Another team in Madrid isolated an extract from a plant called Euphorbia that is found in the Mediterranean. This chemical compound was very useful to reactivate the virus but also protect uninfected cells. Meanwhile, a Los Angeles consortium is trying to synthetize Prostratin, the active constituent of extracts of the tropical plant Homalanthus nutans. This compound is able to activate latent HIV in cells, forcing them to produce new virus, but is difficult to obtain, as the plant supply is limited.
New hopes from clinical data
If a short course of HIV therapy is started immediately and aggressively at the acute HIV infection phase, a functional cure – a lifetime without symptoms, disease progression or prolonged ARV treatment- could be obtained in a significant proportion of patients. This strategy can effectively prevent the HIV reservoir from becoming too large; allowing treatment to be stopped indefinitely without increases in viral load or decreases in CD4 cells.
Because of the size of the global HIV epidemic and the tremendous number of new infections each year, maintaining every single HIV-positive person in the world on antiretroviral therapy will be impossible to implement. Consequently, new strategies to tackle persistent HIV in reservoirs and achieve a functional cure are urgently needed for a society and a world free of AIDS.
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