People born in the last years of the 1980s never knew a world without HIV research or the disease it causes, AIDS, in the news. In the decades since its recognition as a disease that impacted all and not a niche community, we’ve come a long way. But recent developments represent a dramatic shift from prolonged disease management to a potential cure.
1. The HIV Envelope Protein
Virologists from several prestigious universities, who are working in concert to develop an effective vaccine and prevention dynamic, made a crucial discovery. For the HIV vaccine to evade the host immune system, it changes parts of what is known as an envelope protein, gp120. However, some portions of this protein structure must remain constant, or the virus cannot interface with a host cell. By studying the virus processes and interactions with cell receptor sites, the research team noted that these changes render the gp120-141 protein combo vulnerable to two drugs now dubbed entry inhibitors.
2. Stem Cells, Chemo, and Remission
In the past decade, there have been notable cases of remission, with only one instance of a cure. What these cases have in common appear to be factors associated with the treatment of cancer. Specifically, bone marrow and stem cell transplants, cessation of antiretroviral therapy (ART) regimens, and targeted treatment of cancer or other disease vectors, such as chemotherapy. While researchers have noted that, for this approach to work, stem cells must possess what is known as a CCR5 mutation that renders their immune function resistant to HIV. Another factor that may assist in prolonged remission and a potential cure is called GvHD—graft-versus-host disease—that appears to act to suppress the replication of the HIV.
3. Antibodies Are Key
Vaccines typically act to prevent viral infection. They use antibodies and altered forms of viral vectors a bit like training wheels. Healthy patients are vaccinated, create antibodies of their own, and thus never contract the target disease. By culturing CD8 T cells with a dual-functioning antibody. While CD8 cells could not eradicate hidden reservoirs of HIV in lymph nodes, carried by CD4 T cells, this new approach may hold the key. What researchers discovered was that the culturing process removed the muzzle from the accurately dubbed Killer T cells. It permitted them to go into the lymph node and eradicate infected CD4 T cells.
4. Novel Combinations
HIV and AIDS research may have hit upon a potential cure, although the world won’t know until clinical trials and observation periods come to a close. The startling aspect of this possible treatment is that it utilizes two known elements, each of which has been used to treat HIV for years. Later in 2017, a study conducted by scientists at Case Western Reserve University’s School of Medicine will combine them, which has never been done before. Interleukin-2 (IL-2), an antibody that significantly reduces the production of HIV, will be coupled with a lab-engineered monoclonal antibody.
5. A Functional Cure
While repetition, larger sample groups, and control groups must verify the results, a new vaccine has offered five people hope. The premise of therapeutic vaccination is to re-educate the immune systems of those with the virus to fight or suppress its production. Of the original 13 test subjects, five have successfully done so without the aid of ARTs. They were each given three doses of a cancer drug known to stimulate hidden reservoirs of HIV within the body. Then, they received two therapeutic doses of a vaccine known as MVA.HIVconsv. While eight of the participants had to resume ARTs within a month, the remaining five maintain a management equilibrium to date.
We are by no means out of the woods just yet. But the developments in HIV and AIDS treatment this year alone are significant. There is ample reason to embrace the cautious optimism engendered by the results of the most recent HIV research.