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Closing in on a Cure for HIV

OCT 04, 2016 | NICOLA M. PARRY, BVSC, MRCVS, MSC, DIPACVP
A 44-year-old man from Britain could become the first patient ever to be cured of HIV, thanks to a groundbreaking new therapy developed to eradicate the virus.
 
The man is one of 50 people with HIV currently participating in a clinical trial involving the new treatment which aims to target the virus anywhere in the body—even in the dormant cells that typically manage to evade current HIV treatments. He is the first of the participants to complete the course of therapy.
 
HIV treatment currently involves antiretroviral therapy (ART) which suppresses the virus. However, ART alone cannot cure HIV because it only works on HIV-infected cells that are active—it cannot target HIV-infected cells that have become dormant and could still be activated and infect the patient if ART fails. This reservoir of HIV infection in dormant cells is one of the key reasons why it is so difficult to cure HIV infection.
 
Researchers from University of Oxford, University of Cambridge, Imperial College London, University College London, and King's College London, have therefore collaborated to conduct a clinical trial—the RIVER study—to investigate a new therapy that uses a two-stage attack on HIV.
 
This “kick and kill” attack technique initially exposes the virus and then destroys it: First, patients receive a vaccine that boosts the ability of the immune system to locate HIV-infected cells. Next, patients receive the drug Vorinostat, which activates dormant T-cells which produce HIV proteins that make it easier for the immune system to locate the infected cells.
 
So far, 39 of a total of 50 patients have been recruited to the study. While all patients will receive ART during the study, only half will receive the new treatment.
 
The 44-year-old patient currently has no symptoms of HIV after completing the study treatment. Early tests have also shown the virus to be undetectable in his blood. However, he has also been taking ART which already reduces HIV to undetectable levels.
 
“This first participant has now completed the intervention and we have found it to be safe and well tolerated,” said Sarah Fidler, MBBS, PhD, a professor at Imperial College London and co-Principal Investigator on the trial. However, “[o]nly when all 50 study participants have completed the whole study, by 2018, will we be able to tell if there has been an effect on curing HIV,” she emphasized. 
 
Mark Samuels is the managing director of Britain’s National Institute for Health Research Office for Clinical Research Infrastructure, which set up this collaborative effort. "This is one of the first serious attempts at a full cure for HIV,” he told the newspaper. "We are exploring the real possibility of curing HIV.”
 
"This is a huge challenge and it's still early days but the progress has been remarkable," he concluded.
 
Dr. Parry graduated from the University of Liverpool, England in 1997 and is a board-certified veterinary pathologist. After 13 years working in academia, she founded Midwest Veterinary Pathology, LLC where she now works as a private consultant. She is passionate about veterinary education and serves on the Indiana Veterinary Medical Association’s Continuing Education Committee. She regularly writes continuing education articles for veterinary organizations and journals, and has also served on the American College of Veterinary Pathologists’ Examination Committee and Education Committee. 
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