HIV cocktails - on their way out?

Researcher works on a gene-therapy treatment for HIV that could slow the disease's spread within the body

· April 4, 2008, 5:00 am

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While many researchers say an AIDS vaccine is distant - and some declare the prospect unrealistic - Pathology and Laboratory Medicine professor Carl June is pioneering a new gene therapy that could convert the HIV virus in a patient's body into a less harmful form.

While patients already can take "cocktails" of anti-retroviral drugs to manage the AIDS disease, such treatments are costly, ridden with unpleasant side-effects and ineffective in preventing the patient from passing on the virus.

June said he believes these downsides will be overcome by his treatment: a carrier of therapeutic genes that can be inserted into cells to bolster their immune response - possibly by weakening HIV when it attacks those cells.

Ideally, HIV victims treated with June's therapy would only be able to pass on a less virulent form of the virus, resulting in an overall "vaccine effect."

Laboratory and small clinical tests over the past five years have shown that this therapy suppresses HIV from spreading within the body.

June said the treatment "might be a way to vaccinate patients by giving them a virus that's less destructive, so the patient's own immune system could control it, and they wouldn't have to take pills for the rest of their life."

Paula Cannon, who teaches at the University of Southern California and works to develop anti-HIV gene-therapy strategies for children at the Children's Hospital Los Angeles, said that "what I find exciting about gene therapy is it has the potential to be a one-shot solution."

Still, according to Penn Hematology and Oncology professor James Hoxie, only the real vaccine can end the pandemic.

"There's no question treatment is important, but to be infected with HIV is to be infected for life. Nothing has changed that," he said. "You can't turn your back on the need to do everything you can to prevent infection."

About 33 million people worldwide are infected with HIV, according to UNAIDS.

But hope for a vaccine is "almost wishful thinking," Cannon said.

"Everything that nature's told us about the natural infection seems to say that we cannot make a vaccine."

She also said gene therapy has long been notoriously unpopular among medical researchers.

"Gene therapy approaches are kind of hanging off the edge of the cliff by their fingertips" because so few companies are willing to fund the research, she said.

According to Phalguni Gupta, professor of infectious diseases and microbiology at the University of Pittsburgh, few HIV researchers are pursuing gene therapy because it is difficult to alter the genes of the billions of cells affected by a virus.

Gene therapy is "difficult to do, difficult to deliver," he said. "When you put the cells in the body, the body's first reaction is to get rid of them," usually after just a few days.

But the nine patients who received June's treatment displayed what appeared to be "very promising" reactions that lasted even when the therapy was temporarily discontinued for several days.

It will likely be at least five years before June's therapy is approved by the Federal Drug Administration, assuming it proves successful in further clinical trials.

Comments (3)

Gregory P. Dupont

December 31, 1969, 7:00 pm

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This is almoat like the evolution of the virus that William Gibson speculated on in "Virtual Light".i.e;the virus replacing itself with a non-lethal version in th einterest of self-preservation(can't kill the entire host population and continue"

Chris Conlon

December 31, 1969, 7:00 pm

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Research into HIV medicine is progressing very rapidly and it will be interesting to see if this research leads anywhere. But it's important not to under-estimate the efficacy and tolerability of currently available anti-HIV treatment. Although all antiretroviral drugs do cause side-effects, in many cases these are transient or managable. Many HIV physicians are now confident that with the right HIV treatment and care even the currently available therapy could mean that a person with HIV lives a normal lifespan. HIV treatment is becoming easier to take - therapy consisting of just one pill, once a day recently became available. It's also important to correct an inaccuracy in the report. Anti-HIV drugs, by lowering the amount of virus in the body, do significantly reduce the likelihood transmission; indeed there's good evidence from observational studies that patients with an undetectable viral load do not transmit the virus to their sexual partners during unprotected sex. It's vitally important that individuals who might have been at risk of HIV have their infection diagnosed. About 25% of HIV-positive individuals in the US are not aware that they have the virus. This endangers their own health because they are not able to access life-saving treatment and care if they don't know they have the virus. And it can endanger the health of others - there is really convincing evidence that a substantial percentage of new HIV infections are due to people with undiagnosed HIV. Let's hope that we get even better HIV drugs in the future - but if you you under-estimate just how good treatment is now you could deter people from testing and that could cost lives and mean more new infections.

lujia

June 16, 2010, 10:29 pm

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