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Archive for the ‘Cure Watch’ Category

Researchers at Brigham and Women’s Hospital in Boston have discovered that, following bone marrow transplants, two men no longer have detectable HIV in their blood cells.

The finding is significant because it suggests that by giving these patients transplants while they were on anti-retroviral therapy, they may have been cured of the AIDS-causing virus.

“We expected HIV to vanish from the patients’ plasma, but it is surprising that we can’t find any traces of HIV in their cells,” said Dr. Timothy Henrich, one of the researchers studying the two men. “It suggests that under the cover of anti-retroviral therapy, the cells that repopulated the patient’s immune system appear to be protected from becoming re-infected with HIV.”

The findings were presented Thursday at the AIDS 2012 conference in Washington, D.C. The story shares similarities with that of Timothy Ray Brown, also known as “the Berlin patient,” but there are important differences. While the cells used in Brown’s transplant procedure were specifically chosen from a donor who had a genetic mutation that resisted HIV, these patients received transplants with normal cells. Also, the two patients whose cases were presented at the meeting are still taking anti-retroviral medications normally used to treat HIV-positive patients, while Brown is no longer taking these medications.

Further study will need to be done to prove that the two patients are truly cured.

“Studies over time including biopsies of lymphatic tissue would be required,” said Dr. Michael Saag, an infectious disease expert from University of Alabama at Birmingham. He said only time will tell if these patients remain HIV-free.

While it appears from these cases, as well as that of the Berlin patient, that altering a patient’s immune system may lead to a “cure” for HIV, bone marrow transplants are currently too costly and dangerous for all HIV patients to be able to undergo them.

Separately, scientists are trying to use gene therapy to alter patients’ immune systems to free them of HIV.  Most of the research in this field is very preliminary, but scientists at the Fred Hutchinson Cancer Research Center are trying to perform stem cell transplants with cells that have been genetically modified to be resistant to HIV, much like the cells that the Berlin patient received.

“We have not yet transplanted any patient as part of our study,” said Dr. Hans-Peter Kiem of the Clinical Research Division at Fred Hutchinson Cancer Research Center and an attending transplant physician at Seattle Cancer Care Alliance. But Kiem and his research team have recently been awarded a research grant to further investigate stem cell transplantation as treatment as a means to find a cure for HIV.

To read full article CLICK HERE

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Hunt for the Cure

AIDS specialists aim to jump-start hunt for a cure

WASHINGTON (AP) — For years it seemed hopeless. Now the hunt for a cure for AIDS is back on.

International AIDS specialists on Thursday released what they call a road map for research toward a cure for HIV — a strategy for global teams of scientists to explore a number of intriguing leads that just might, years from now, pan out.

“Today’s the first step,” said French Nobel laureate Francoise Barre-Sinoussi, co-discoverer of the HIV virus who also co-chaired development of the strategy.

“No one thinks it’s going to be easy,” added strategy co-chair Dr. Steven Deeks of the University of California, San Francisco. “Some don’t think it’s possible.”

The announcement came just before the International AIDS Conference begins on Sunday, when more than 20,000 scientists, activists and policymakers gather in the nation’s capital with a far different focus: how to dramatically cut the spread of the AIDS virus, what they call “turning the tide” of the epidemic, using some powerful tools already in hand.

Chief among them is getting more of the world’s 34 million HIV-infected people on life-saving medications, so they stay healthier and are less likely to infect others. By itself, that is a huge hurdle. Just 8 million of the 15 million treatment-eligible patients in AIDS-ravaged poor regions of the world are getting the drugs.

But Barre-Sinoussi, president-elect of the International AIDS Society, which hosts the conference, said that lifelong treatment, as good as it is, isn’t the end-all solution — and that science finally is showing that a cure “could be a realistic possibility.”

The panelists refused to estimate Thursday how much this research would cost. But already, the National Institutes of Health has increased spending on cure-related research, about $56 million last year, according to a report in this week’s issue of the journal Nature. Scientists attempting cure research will meet Friday and Saturday, ahead of the AIDS conference, to compare notes.

And the new strategy won praise from Michel Sidibe, executive director of UNAIDS, the Joint United Nations Program on HIV and AIDS.

“The previous generation fought for treatment,” he said. “Our generation must fight for a cure.”

Today’s anti-HIV drugs can tamp down the virus to undetectable levels — but they don’t eradicate it. Instead, tiny amounts of the virus can hide out in different tissues and roar back if medication is stopped.

That means there’s no certainty of developing a cure.

“I’m not sure we can, but we’re going to try,” Dr. Anthony Fauci, director of NIH’s National Institute of Allergy and Infectious Diseases, said in a recent interview. “This virus is uncanny in its ability to be able to integrate itself into a cell, as a reservoir, and no matter what we’ve done so far, we have not been able to eliminate that reservoir.”

Yet one person in the world apparently has been cured: Timothy Ray Brown of San Francisco, who in 2006 was living in Berlin when in addition to his HIV, he got leukemia.

Brown underwent a blood stem cell transplant — what once was a bone marrow transplant — to treat the cancer. His own immune system was destroyed. And his German transplant surgeon found a donor who was among the 1 percent of whites who have a gene mutation that makes them naturally resistant to HIV — their cells lack the specific doorway the virus uses to get inside.

It worked. Brown has been off HIV medications for five years and is doing well, Deeks said Thursday.

That dangerous and expensive transplant isn’t a practical solution, but it has sparked a variety of research into other possible ways to eradicate HIV. Already, 12 early-stage studies involving small numbers of patients — fewer than 200 people worldwide — are under way, the international panel said Thursday. Results to see if any are promising enough to pursue should be out in the next year or two.

The priorities of the new cure research strategy:

Determine why HIV hibernates and persists.

—Learn why some people are naturally resistant. In addition to that 1 percent of people with the gene mutation, researchers now are studying a small group of patients in France who started medication soon after they were infected and many years later were able to stop the drugs without the virus rebounding.

Develop and test strategies to make HIV patients more naturally resistant. Already gene therapy studies are under way to knock that HIV doorway out of people’s own infection-fighting blood cells.

Learn where all those secret reservoirs are.

Develop strategies to attack the reservoirs. One new attempt uses drugs to wake up the dormant HIV so the immune system can spot and attack it, what Deeks called the “shock and kill approach.” Last spring, University of North Carolina, Chapel Hill, researchers reported that a drug normally used for lymphoma made some latent HIV rapidly detectable in six patients. Deeks has a similar study under way using an old anti-alcoholism drug.

Develop good tests to measure these tiny amounts of dormant HIV, crucial to telling if any cure attempts are promising short of taking patients off their regular medication.

To read full article: CLICK HERE

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Timothy Ray Brown, known as the Berlin Patient, is thought to be the first patient ever to be cured of HIV infection.

Brown, 45, had two bone marrow transplants in Berlin in 2007 and 2008 to treat leukemia that is apparently unrelated to his HIV infection. The blood cells for the transplants came from a donor with a genetic mutation that makes his cells immune to HIV — they lack receptors the virus needs to gain entry to cells.

The transplants appear to have snuffed out Brown’s HIV infection. After an initial spike, the virus disappeared from his system — even though he is no longer taking anti-HIV drugs.

But new data presented last week in Spain raise a question about whether there are minute traces of HIV in some tissues — not whole virus capable of replicating, but pieces of viral genes.

Researchers have combed through 9 billion of Brown’s cells, retrieved from his blood, lymph nodes, spinal fluid and intestinal tract. Four different labs could find no trace of HIV in his blood cells. But three groups, using tests at the very limit of detectability, think they have identified bits of HIV genetic material — two from blood plasma and one from intestinal cells.

It could be a false reading, due to laboratory contamination, scientists say. For one thing, the fragments of viral genes don’t completely match those of the HIV Brown harbored before his transplants.

But AIDS researchers stress that even if the new findings constitute real evidence of HIV in his system, they don’t mean he’s not cured.

Although, it’s clear the findings do raise questions about what sort of cure he has.

Scientists hoped Brown had a so-called sterilizing cure — that is, the HIV has been completely eradicated from every cell in his body.

But long and bitter experience with HIV has shown that the virus can hide out in the genes of very long-lived resting immune cells. As these latently infected cells get activated over the years, HIV might reappear in the form of the whole virus or perhaps pieces of its genes.

But if that is happening in Brown, there is no evidence that the virus is actively replicating. To do that, it would need to infect other cells and hijack their genetic machinery to crank out more virus. Since Brown’s replacement immune system (from the bone marrow donor) doesn’t have the entry portal HIV needs, these new viruses (if they exist in his case) can’t spark a new viral conflagration.

Therefore, he may be functionally cured, even if he’s not totally free of HIV.

That’s what Brown himself thinks may be going on, from his discussions with researchers who have been poking and prodding him for the past five years.

“With a sterilizing cure, they have to be sure that a patient is completely clear of HIV — that they’ve looked everywhere and can’t find any,” Brown says. “In my case, I still have the dead virus and it’s still showing up in some ways, and so I’ve got a functional cure.”

To him, that’s just as good.

Brown is particularly upset at suggestions that he has become reinfected with HIV through unsafe sex. “That is not the case,” he says. “It’s very difficult for me to listen to those things and read those things.”

To read full article CLICK HERE

 

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A Groundbreaking HIV Vaccine Could Be on the Horizon

A unique and potentially landmark vaccine against the HIV virus has been shown to be safe and effective in animals. Now researchers have received the green light to test it in humans.

WEDNESDAY Dec. 21, 2011 — On Tuesday, the U.S. Food and Drug Administration (FDA) gave Canadian researchers approval to begin testing a potential HIV vaccine in humans beginning in January, according to HealthDay.

University of Western Ontario scientists, backed by the pharmaceutical company Sumagen, have already tested the vaccine in lab animals. These early tests demonstrated a strong immune response and no adverse effects.

The SAV001 vaccine works by using a dead HIV-1 virus that is non-pathogenic — meaning it’s genetically engineered to prevent spreading HIV to vaccine recipients — to trigger an immune response in patients, killing any cells that might become infected with HIV.

Though scientists have attempted to create HIV vaccines in the past, certain genes or proteins from the HIV virus were used instead of the whole virus. The researchers developing the SAV001 vaccine are the first to use this new approach.

Because this potential HIV vaccine uses the whole virus, it is similar to vaccines used for polio and the flu.

“When [researchers] came out with the polio vaccine, polio was eradicated in developed countries. I’d like to see that I can do that against the HIV infection,” says Chil-Yong Kang, MD, a virologist at the University of Western Ontario.

The Phase I trial — which will test the vaccine in 40 HIV-positive volunteers — is set to begin in January. If successful, further clinical trials will be performed to determine the vaccine’s effectiveness.

The Phase II trial will test about 600 HIV-negative people who are at high risk for the virus, and the

Phase III trial will test about 6,000 HIV-negative people who are at high risk for the virus.

To read full article CLICK HERE

 

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From the Huffington Post

“The report that ushered in an epidemic 30 years ago this week was startling: Five otherwise healthy gay men in Los Angeles had come down with a rare form of pneumonia, and two of them had already died. Unnerving as this news was, none of us could have predicted the horrors ahead.

-Early studies showed that condoms were highly effective barriers to HIV infection. Mother-to-child transmission of the virus has been virtually eliminated in the developed world.

-Male circumcision has been shown to reduce the risk for males of contracting HIV through heterosexual sex.

-Last July researchers showed that a vaginal microbicide gel that women can use before heterosexual sex can sharply decrease their risk of contracting HIV.

-In November, a study showed that high-risk men who have sex with men who diligently took an ARV while HIV-negative reduced their chances of contracting the virus by more than 90 percent.

-And in May a clinical study finally confirmed what many in the scientific and medical communities have believed for years, namely that a healthy HIV-positive person on ARVs is much less likely to pass on the virus to his or her partner.

-None of these interventions alone will end the epidemic. But if used in combination and scaled up among vulnerable populations in particular, they could lead to quick, substantial and worldwide reductions in the incidence of HIV infection.

Furthermore, smart investments in HIV prevention will pay off handsomely not only in lives saved, but also in treatment costs averted.

-Ending the global AIDS epidemic will ultimately require an effective vaccine or a cure.

-Thirty years into the AIDS epidemic, we are faced with a choice. Are we content to tinker at the fringes of the epidemic, spending untold billions to treat a fraction of those in need for decades into the future? Or can we summon the political will to effectively deploy the prevention interventions that are already available to us and to make the necessary investments in research that could end this epidemic in our lifetime?

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Vaccine is found to clear the body of HIV virus

Thursday, 12 May 2011 – Belfast telegraph

An experimental vaccine could prove to be the ultimate weapon against AIDS, research suggests. Studies indicate it has the potential to clear the body of all traces of the AIDS virus, HIV. Uniquely, the injected vaccine is carried by a persistent virus which remains in the body for life. Cytomegalovirus (CMV) enables the immune system to be constantly on the alert for HIV.

Researchers in the US used different versions of the vaccine against a monkey form of the AIDS virus, Simian Immunodeficiency Virus (SIV), with outstanding results. More than half the rhesus macaques monkies treated responded to the point where even the most sensitive tests detected no signs of SIV. To date, most of the animals have maintained control over the virus for more than a year, gradually showing no indication they had ever been infected. Unvaccinated monkeys infected with SIV went on to develop the monkey equivalent of AIDS, caused by the collapse of their immune systems. The findings suggest the vaccine could be effective enough to rid the body of immunodeficiency virus completely, according to the scientists writing in the journal ‘Nature’.

Conventional antiretroviral therapies are able to control HIV infection, but cannot clear the virus from its hiding places within the immune system’s white blood cells.

Study leader Dr Louis Picker, from Oregon Health & Science University’s Vaccine and Gene Therapy Institute, said: “The next step in vaccine development is to test the vaccine candidate in clinical trials in humans. “For a human vaccine, the CMV vector would be weakened sufficiently so that it does not cause illness, but will still protect against HIV.” CMV belongs to the herpes family of viruses, and like other members of the group never leaves the body once an infection has occurred. An estimated half of all adults in the UK carry CMV but suffer no or few symptoms. The virus is spread through bodily fluids such as saliva and urine. When symptoms do occur, they are similar to those of flu including a high temperature and swollen glands as well as tiredness. People with weakened immune systems can have a more severe response.

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How to interpret this: This is NOT the first time we’ve heard about a “vaccine that can cure AIDS”. Don’t put a whole lot of faith in this until it gets into human trials and we see more definitive results. But let’s keep an eye on this. It’s still exciting.
Thanks to Jim for finding this.
-Steve

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Poz Magazine had another article on Timothy Brown, The Berlin Patient. Link

Timothy Brown is an American living in Germany. He had both HIV and leukemia. As part of his leukemia treatment, he had to have a bone marrow transplant in 2007. His doctors gave him a transplant from a donor whose cells where resistant to the AIDS virus (CCR5 delta-32 mutation). After his treatment, he stopped taking his HIV medications.

The CCR5 delta-32 mutation is extremely rare. It requires a delta-32 mutation from both parents and only occurs in 1% of the Caucasian population (usually northern and western Europe) and none of the African population. There was no data on other ethnicities.

It was expected that his HIV would mutate to the CXCR4 virus. That didn’t happen. Tests today show that the patient has no viral load, and even the HIV antibodies declined to the point that the patient has no antibody reactivity to HIV core antibodies. In other words, this patient would test HIV-negative.

Although this is very exciting news, the treatment that Brown went through is risky and painful. One third of patients don’t survive. In other words, 33% of people going through this treatment die.

The good news is that we now know that HIV can be cured, not just managed. It opens up new avenues of research, gene therapy, and stem cell treatements.

D

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