Another step toward an HIV cure

Existing drug may help bring HIV out of hiding so that it can be attacked

Jeffrey Bouley
Researchers at the University of North Carolina Chapel Hill (UNC) have shown that HIV can be coaxed of out hiding in a person's body so that it could, theoretically, be more effectively attacked and perhaps eradicated.
 
The idea is to encourage production of the dormant AIDS-causing virus inpatients in a safe way so that it can be detected and attacked by the immune system. The UNC researchers, using the Merck drug Zolinza (vorinostat, which is for treating cutaneous T-cell lymphoma), showed that they could coax the virus out frominside certain immune-system cells, where it typically evades drugs meant to fight AIDS.
 
The finding were announced at the recent 19th annualConference on Retroviruses and Opportunistic Infections in Seattle,Wash., but there are, of course, caveats. For one thing, the study involved six men with HIV infection, meaning it's a small and pretty homogenous group. Also, other studies released at the same event in Seattle suggest thatmerely getting HIV to come out of hiding isn't enough for the body to be able to kill them.
 
Still, it is a start to fighting a virus that is very good at evading the body's immune defenses.
 
None of the patients were cured in the trial, but the researchers (led by Dr. David Margolis)  hope that Zolinzaor similar drugs may be able to help purge HIV from patients' bodies. Margolis told Bloomberg he expects to hear soon from the U.S. Food andDrug Administration for approval foran additional test using more doses of Zolinza.
 
"What people want to know is when can someone go to adoctor and be handed a pill and be cured," Margolis told Bloomberg. "That's decades away. Think of it more in terms ofcuring cancer. I think in 10 years someone with HIV infectioncould go to a specialist and get a complicated treatment andhave some likelihood of a prolonged remission of their HIV."
 
As noted by the journal Nature, previous studies had suggested that suberoylanilide hydroxamicacid (SAHA)—a class of which Zolinza/vorinostat is a part—could "push the virus out of its slumber, but the approachhad not been tested in people." That's where Margolis, amolecular virologist, and his UNC team came in,  treating six people with a single dose of SAHA and testing its effect onCD4+ T cells — immune cells that are targeted for infectionby HIV.
 
As Nature notes, the study found that SAHA did kick-start transcription of HIV inlatently infected CD4+ T cells; researchers detected nearly five times as many HIV transcripts in the patients' resting CD4+ T cells after treatment as before. There were no serious side effects.
 
"This study provides the first proof-of-conceptdemonstration of disruption of latency, which is a significant steptowards eradication" of HIV from the body, said Margolis of the results.


Jeffrey Bouley

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