Dec. 21, 2022 by Tim Murphy
“A T cell (red) that’s been infected with HIV produces many copies of the virus (blue), as shown in this colorized transmission electron micrograph. HIV cure research continues to seek out ways to end this process once and for all.” Photo: NIAID
“It seems as though a day did not go by in 2022 when we didn’t see a headline suggesting that A BIG HIV CURE BREAKTHROUGH was right around the corner. So many early trials seem to be in play. And of course, we learned about the “New York patient,” the third known person to be cured of HIV via stem-cell transplantation in the course of treatment for cancer.”
“But, as you might imagine, it’s never as simple as newspaper headlines make it out to be. Now, that’s not to say that nothing hopeful has happened—but the picture is still complicated. To help explain where things stand in cure research and why these trials are so important, TheBody spoke with Richard Jefferys―the basic science, vaccines, and Cure Project director of Treatment Action Group.”
“Tim Murphy: Hi, Richard! Thank you as ever for chatting with us. So, blunt question to start: What’s the state of cure research? As vibrant as headlines often suggest?
Richard Jefferys: There’s some encouraging evidence of progress but still no real clear path toward a universally applicable cure. There’s been progress toward interventions that may benefit the immune response to HIV, but it’s still frustratingly early days, with a lot of early-stage laboratory research going on.”
“Murphy: Have any other ways of eradicating HIV from the body been proven?
Jefferys: No. We’ve started to see evidence that what are called broadly neutralizing antibodies, or bNAbs, can help enact the immune response to HIV in a way that might trim the size of the HIV reservoir [reserve of viable HIV in the body]. There was a Rockefeller University study where giving a combination of two bNAbs correlated with reduction of HIV in the body—but it was only borderline statistically significant. And there was a second study from Denmark also involving a bNAb that seemed to increase the pace of clearance of HIV-infected cells. But unfortunately, only one person has managed to go a few years like this. Still, that provides anecdotal evidence that you might be able to get control of HIV in the body.
Right now there’s a bit of a trend toward combining bNAbs with therapeutic vaccines or other immune modulators. What we want is a study where maybe up to half of people extended post-treatment natural control of HIV, but we haven’t seen that yet.”
“Murphy: What is the current scope of research in actual people?
Jefferys: Most of those studies are early-phase, looking at safety or very preliminarily looking for efficacy. We’re definitely starting to see larger human studies of the bNAbs—the RIO study, and a similar one in France. I think they’ll have more results to share over the next year or two.
Murphy: Do you think they’ll work?
Jefferys: I’m not sure. I think more likely they’ll help provide guidance on how to best use these interventions, such as when to give the bNAbs.”
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