1. Dear Drugs-Forum readers: We are a small non-profit that runs one of the most read drug information & addiction help websites in the world. We serve over 4 million readers per month, and have costs like all popular websites: servers, hosting, licenses and software. To protect our independence we do not run ads. We take no government funds. We run on donations which average $25. If everyone reading this would donate $5 then this fund raiser would be done in an hour. If Drugs-Forum is useful to you, take one minute to keep it online another year by donating whatever you can today. Donations are currently not sufficient to pay our bills and keep the site up. Your help is most welcome. Thank you.
    PLEASE HELP

Scientists on brink of HIV cure

By source, Apr 29, 2013 | | |
Rating:
4/5,
  1. source
    Danish scientists are expecting results that will show that “finding a mass-distributable and affordable cure to HIV is possible”.

    They are conducting clinical trials to test a “novel strategy” in which the HIV virus is stripped from human DNA and destroyed permanently by the immune system.

    The move would represent a dramatic step forward in the attempt to find a cure for the virus, which causes Aids.

    The scientists are currently conducting human trials on their treatment, in the hope of proving that it is effective. It has already been found to work in laboratory tests.

    The technique involves releasing the HIV virus from “reservoirs” it forms inside DNA, bringing it to the surface of the cells. Once it comes to the surface, the body’s natural immune system can kill the virus through being boosted by a “vaccine”.

    In vitro studies — those that use human cells in a laboratory — of the new technique proved so successful that in January, the Danish Research Council awarded the team 12 million Danish kroner (£1.5 million) to pursue their findings in clinical trials with human subjects.

    These are now under way, and according to Dr Ole Søgaard, a senior researcher at the Aarhus University Hospital in Denmark and part of the research team, the early signs are “promising”.

    “I am almost certain that we will be successful in releasing the reservoirs of HIV," he said.

    “The challenge will be getting the patients’ immune system to recognise the virus and destroy it. This depends on the strength and sensitivity of individual immune systems.”

    Fifteen patients are currently taking part in the trials, and if any of them are found to have successfully been cured of HIV, the “cure” will be tested on a wider scale, aided by an immune system booster.

    Dr Søgaard stressed that a cure is not the same as a preventative vaccine, and that raising awareness of unsafe behaviour, including unprotected sex and sharing needles, remains of paramount importance in combating HIV.

    With modern HIV treatment, a patient can live an almost normal life, even into old age, with limited side effects.

    However, if medication is stopped, HIV reservoirs become active and start to produce more of the virus, meaning that symptoms can reappear within two weeks.

    Finding a cure would free a patient from the need to take continuous HIV medication, and save health services billions of pounds.

    The technique is being researched in Britain, but studies have not yet moved on to the clinical trial stage. Five universities — Oxford, Cambridge, Imperial College, London, University College, London and King’s College, London — have jointly formed the Collaborative HIV Eradication of Reservoirs UK Biomedical Research Centre group (CHERUB), which is dedicated to finding an HIV cure.

    They have applied to the Medical Research Council for funding to conduct clinical trials, which will seek to combine techniques to release the reservoirs of HIV with immunotherapy to destroy the virus.

    In addition, they are focusing on patients that have only recently been infected, as they believe this will improve chances of a cure. The group hopes to receive a funding decision in May.

    “When the first patient is cured in this way it will be a spectacular moment,” says Dr John Frater, a clinical research fellow at the Nuffield School of Medicine, Oxford University, and a member of the CHERUB group.

    “It will prove that we are heading in the right direction and demonstrate that a cure is possible. But I think it will be five years before we see a cure that can be offered on a large scale.”

    The Danish team’s research is among the most advanced and fast moving in the world, as that they have streamlined the process of putting the latest basic science discoveries into clinical testing.

    This means that researchers can progress more quickly to clinical trials, accelerating the process and reaching reliable results sooner than many others.

    The technique uses drugs called HDAC Inhibitors, which are more commonly used in treating cancer, to drive out the HIV from a patient’s DNA. The Danish researchers are using a particularly powerful type of HDAC inhibitor called Panobinostat.

    Five years ago, the general consensus was that HIV could not be cured. But then Timothy Ray Brown, an HIV sufferer — who has become known in the field as the Berlin Patient — developed leukaemia.

    He had a bone marrow transplant from a donor with a rare genetic mutation that made his cells resistant to HIV. As a result, in 2007 Mr Brown became the first man to ever be fully cured of the disease.

    Replicating this procedure on a mass scale is impossible. Nevertheless, the Brown case caused a sea change in research, with scientists focusing on finding a cure as well as suppressing the symptoms.

    Two principal approaches are currently being pursued. The first, gene therapy, aims to make a patient’s immune system resistant to HIV. This is complex and expensive, and not easily transferrable to diverse gene pools around the world.

    The second approach is the one being pursued by Dr Søgaard and his colleagues in Denmark, the CHERUB group in Britain, and by other laboratories in the United States and Europe.

    By Jake Wallis Simons, Telegraph, 27 Apr 2013
    http://www.telegraph.co.uk/health/healthnews/10022664/Scientists-on-brink-of-HIV-cure.html

Comments

  1. Calliope
    Some related stories looking at the potential for early anti-retroviral drug treatment to actually cure HIV infection. Sadly, the most recent story reports that the Mississippi child deemed cured in 2013 has now shown signs of H.I.V. infection again. The New England Journal of Medicine report about Mississippi baby can be read here.
    -------------------------------------------------------------------

    In Medical First, a Baby With H.I.V. Is Deemed Cured
    March 3, 2013

    Doctors announced on Sunday that a baby had been cured of an H.I.V. infection for the first time, a startling development that could change how infected newborns are treated and sharply reduce the number of children living with the virus that causes AIDS.

    The baby, born in rural Mississippi, was treated aggressively with antiretroviral drugs starting around 30 hours after birth, something that is not usually done. If further study shows this works in other babies, it will almost certainly be recommended globally. The United Nations estimates that 330,000 babies were newly infected in 2011, the most recent year for which there is data, and that more than three million children globally are living with H.I.V.

    If the report is confirmed, the child born in Mississippi would be only the second well-documented case of a cure in the world. That could give a lift to research aimed at a cure, something that only a few years ago was thought to be virtually impossible, though some experts said the findings in the baby would probably not be relevant to adults.

    The first person cured was Timothy Brown, known as the Berlin patient, a middle-aged man with leukemia who received a bone-marrow transplant from a donor genetically resistant to H.I.V. infection.

    “For pediatrics, this is our Timothy Brown,” said Dr. Deborah Persaud, associate professor at the Johns Hopkins Children’s Center and lead author of the report on the baby. “It’s proof of principle that we can cure H.I.V. infection if we can replicate this case.”

    Dr. Persaud and other researchers spoke in advance of a presentation of the findings on Monday at the Conference on Retroviruses and Opportunistic Infections in Atlanta. The results have not yet been published in a peer-reviewed medical journal.

    Some outside experts, who have not yet heard all the details, said they needed convincing that the baby had truly been infected. If not, this would be a case of prevention, something already done for babies born to infected mothers.

    “The one uncertainty is really definitive evidence that the child was indeed infected,” said Dr. Daniel R. Kuritzkes, chief of infectious diseases at Brigham and Women’s Hospital in Boston.

    Dr. Persaud and some other outside scientists said they were certain the baby — whose name and gender were not disclosed — had been infected. There were five positive tests in the baby’s first month of life — four for viral RNA and one for DNA. And once the treatment started, the virus levels in the baby’s blood declined in the pattern characteristic of infected patients.

    Dr. Persaud said there was also little doubt that the child experienced what she called a “functional cure.” Now 2 1/2, the child has been off drugs for a year with no sign of functioning virus.

    The mother arrived at a rural hospital in the fall of 2010 already in labor and gave birth prematurely. She had not seen a doctor during the pregnancy and did not know she had H.I.V. When a test showed the mother might be infected, the hospital transferred the baby to the University of Mississippi Medical Center, where it arrived at about 30 hours old.

    Dr. Hannah B. Gay, an associate professor of pediatrics, ordered two blood draws an hour apart to test for the presence of the virus’ RNA and DNA.

    The tests found a level of virus at about 20,000 copies per milliliter, fairly low for a baby. But since tests so early in life were positive, it suggests the infection occurred in the womb rather than during delivery, Dr. Gay said.

    Typically a newborn with an infected mother would be given one or two drugs as a prophylactic measure. But Dr. Gay said that based on her experience, she almost immediately used a three-drug regimen aimed at treatment, not prophylaxis, not even waiting for the test results confirming infection.

    Virus levels rapidly declined with treatment and were undetectable by the time the baby was a month old. That remained the case until the baby was 18 months old, after which the mother stopped coming to the hospital and stopped giving the drugs.

    When the mother and child returned five months later, Dr. Gay expected to see high viral loads in the baby. But the tests were negative.

    Suspecting a laboratory error, she ordered more tests. “To my greater surprise, all of these came back negative,” Dr. Gay said.

    Dr. Gay contacted Dr. Katherine Luzuriaga, an immunologist at the University of Massachusetts, who was working with Dr. Persaud and others on a project to document possible pediatric cures. The researchers, sponsored by amfAR, the Foundation for AIDS Research, put the baby through a battery of sophisticated tests. They found tiny amounts of some viral genetic material but no virus able to replicate, even lying dormant in so-called reservoirs in the body.

    There have been scattered cases reported in the past, including one in The New England Journal of Medicine in 1995, of babies clearing the virus, even without treatment.

    Those reports were greeted skeptically, particularly since testing methods were not very sophisticated back then. But those reports and this new one could suggest there is something different about babies’ immune systems, said Dr. Joseph McCune of the University of California, San Francisco.

    One hypothesis is that the drugs killed off the virus before it could establish a hidden reservoir in the baby. One reason people cannot be cured now is that the virus hides in a dormant state, out of reach of existing drugs. When drug therapy is stopped, the virus can emerge from hiding.

    “That goes along with the concept that, if you treat before the virus has had an opportunity to establish a large reservoir and before it can destroy the immune system, there’s a chance you can withdraw therapy and have no virus,” said Dr. Anthony S. Fauci, the director of the National Institute for Allergy and Infectious Diseases. Adults, however, typically do not know they are infected right as it happens, he said.

    Dr. Steven Deeks, professor of medicine at the University of California, San Francisco, said if the reservoir never established itself, then he would not call it a true cure, though this was somewhat a matter of semantics. “Was there enough time for a latent reservoir, the true barrier to cure, to establish itself?” he said.

    Still, he and others said, the results could lead to a new protocol for quickly testing and treating infants.

    In the United States, transmission from mother to child is rare — several experts said there are only about 200 cases a year or even fewer — because infected mothers are generally treated during their pregnancies.

    If the mother has been treated during pregnancy, babies are typically given six weeks of prophylactic treatment with one drug, AZT, while being tested for infection. In cases like the Mississippi one, where the mother was not treated during pregnancy, standards have been changing, but typically two drugs are used.

    But women in many developing countries are less likely to be treated during pregnancy. And in South Africa and other African countries that lack sophisticated testing, babies born to infected mothers are often not tested until after six weeks, said Dr. Yvonne Bryson, chief of global pediatric infectious disease at the University of California, Los Angeles.

    Dr. Bryson, who was not involved in the Mississippi work, said she was certain the baby had been infected and called the finding “one of the most exciting things I’ve heard in a long time.”

    Studies are being planned to see if early testing and aggressive treatment can work for other babies. While the bone marrow transplant that cured Mr. Brown is an arduous and life-threatening procedure, the Mississippi treatment is not and could become a new standard of care.

    While it might be difficult for some poorer countries to do, treating for only a year or two would be cost effective, “sparing the kid a lifetime of antiretroviral therapy,” said Rowena Johnston, director of research at amfAR.

    NYTimes
    March 3, 2013
    By ANDREW POLLACK and DONALD G. McNEIL Jr.
    http://www.nytimes.com/2013/03/04/health/for-first-time-baby-cured-of-hiv-doctors-say.html
    ------------------------------------------------------------

    Early Treatment Is Found to Clear H.I.V. in a 2nd Baby
    MARCH 5, 2014

    BOSTON — When scientists made the stunning announcement last year that a baby born with H.I.V. had apparently been cured through aggressive drug treatment just 30 hours after birth, there was immediate skepticism that the child had been infected in the first place.

    But on Wednesday, the existence of a second such baby was revealed at an AIDS conference here, leaving little doubt that the treatment works. A leading researcher said there might be five more such cases in Canada and three in South Africa.

    And a clinical trial in which up to 60 babies who are born infected will be put on drugs within 48 hours is set to begin soon, another researcher added.

    If that trial works — and it will take several years of following the babies to determine whether it has — the protocol for treating all 250,000 babies born infected each year worldwide will no doubt be rewritten.

    “This could lead to major changes, for two reasons,” said Dr. Anthony S. Fauci, executive director of the National Institute for Allergy and Infectious Diseases. “Both for the welfare of the child, and because it is a huge proof of concept that you can cure someone if you can treat them early enough.”

    The announcement was the third piece of hopeful news in two days about the virus that causes AIDS.

    On Tuesday, scientists reported that injections of long-lasting AIDS drugs fended off infection in monkeys, and on Wednesday, researchers announced a “gene editing” advance that might enable immune cells to repel the virus.

    The first infant to make an apparent recovery from H.I.V. infection, now famous as the “Mississippi baby,” was described last March at the Conference on Retroviruses and Opportunistic Infections, the same annual meeting where the new case was reported on Wednesday.

    The Mississippi child, now more than 3 years old, is still virus-free, said Dr. Deborah Persaud, a virologist who has run ultrasensitive tests on both children in her lab at the Johns Hopkins Children’s Center in Baltimore.

    The second baby, a girl born at Miller Children’s Hospital in Long Beach, Calif., is now 9 months old and apparently free of the virus that causes AIDS.

    Her mother, who has advanced AIDS and is mentally ill, arrived in labor; she had been prescribed drugs to protect her baby but had not taken them.

    Four hours after the birth, a pediatrician, Dr. Audra Deveikis, drew blood for an H.I.V. test and immediately started the baby on three drugs — AZT, 3TC and nevirapine — at the high doses usually used for treatment of the virus.

    The normal preventive regimen for newborns would be lower doses of two drugs; doctors usually do not use the more aggressive treatment until they are sure the baby is infected, and then sometimes not in the first weeks.

    “Of course I had worries,” Dr. Deveikis said in an interview here. “But the mother’s disease was not under control, and I had to weigh the risk of transmission against the toxicity of the meds.”

    “I’d heard of the Mississippi baby, I’d watched the video,” she added. “I knew that if you want to prevent infection, early treatment is critical.”

    The Long Beach baby is now in foster care, she said. The mother is still alive as well.

    It is incorrect to describe the baby as “cured” or even as “in remission” because she is still on the drugs, Dr. Persaud said. But because the most sensitive blood tests can find no virus capable of replicating, she describes the baby as “having sero-reverted to H.I.V.-negative.”

    Both DNA and RNA of the virus were found in the baby’s early blood and spinal fluid samples, so Dr. Persaud said it was virtually certain she was infected at birth. The virus began to disappear six days after birth and was undetectable within 11 days.

    It is considered medically unethical to stop the baby’s drugs now, but Dr. Deveikis and Dr. Yvonne J. Bryson, a pediatric AIDS expert at the University of California, Los Angeles, who is also working on the case, said they would consider stopping them briefly to see what happens if the baby is still virus-free at age 2.

    Dr. Bryson is one of three investigators who will lead the clinical trial seeking 60 babies.

    Obstetricians and pediatricians in the United States, South Africa and Brazil will be alerted to watch for babies being born to mothers who have not taken drugs to prevent mother-child transmission and to get them on full antiretroviral treatment immediately, even before the first blood test has been finished. (In the United States, fewer than 200 children each year are born with H.I.V.)

    The trial will be funded by Dr. Fauci’s institute and be part of the Impact series of trials concentrating on preventing viral transmission to newborns.

    “When we described the Mississippi baby, we were met with some skepticism,” she said. The Long Beach baby “was definitely infected.”

    The Mississippi baby was born to a mother who got no prenatal care and was unaware that she was infected. Worried doctors at a local hospital transferred the baby to the University of Mississippi Medical Center, where a pediatrician, Dr. Hannah B. Gay, started aggressive antiretroviral treatment about 30 hours after birth.

    Then, 18 months later, the mother stopped taking the baby to appointments and stopped giving the drugs. Five months later, when she came to an appointment, doctors feared the baby would be teeming with virus.
    Instead, to their astonishment, they found none. And Dr. Persaud’s testing has found none, despite using tests normally able to detect dormant virus in adult patients on successful treatment.

    Although antiretrovirals prevent the virus from replicating, a small amount usually persists in reservoirs throughout the body, integrated into the DNA of cells. Dr. Persaud’s test can activate those cells and force them to “spit out” the virus, where it can be detected.

    Dr. Steven G. Deeks, an AIDS expert at the University of California, San Francisco, said the Long Beach baby offered more convincing evidence that starting therapy virtually at birth seems to kill the virus before it establishes a permanent reservoir.

    “But it sure would be nice to have a way to decide when to stop” the treatment, he added. “That’s the next question.”

    NYTimes
    http://www.nytimes.com/2014/03/06/h...ises-hope-for-a-way-to-rid-babies-of-hiv.html
    ---------------------------------------------------------------------------

    Evidence of H.I.V. Found in a Child Said to Be Cured
    JULY 10, 2014

    A child in Mississippi who was thought to have been cured of H.I.V. with aggressive drug treatment immediately after birth is now showing signs of infection with the virus, federal health officials announced Thursday — a serious setback to hopes for a cure for AIDS.

    The report in March 2013 that the child had apparently been cured raised the possibility that aggressive early treatment might be able to reverse infections in newborns — and perhaps even in newly infected adults. About 2.3 million people around the world were newly infected with H.I.V. in 2012, the last year for which figures were available; 260,000 were infants infected at birth or immediately afterward.

    So Thursday’s announcement was especially deflating. During a telephone news conference held by the National Institutes of Health, Dr. Hannah B. Gay, the pediatrician at the University of Mississippi Medical Center in Jackson who first put the child on large doses of antiretroviral drugs, said it was “like a punch in the gut.”

    With hopes raised by the Mississippi case, doctors had made plans for a worldwide clinical trial in which about 450 babies — chosen because their infected mothers had no testing or treatment before the births — would be put on the three-drug regimen called triple therapy.

    If those who were infected with H.I.V. showed no virus after 48 weeks of treatment, the plan was to stop their drugs and see if they had been cured before the virus had a chance to establish a reservoir of infected cells.

    But not a single baby has yet been enrolled in the trial, and in light of the failure to cure the Mississippi baby, “We’ve got to go back and look at the trial’s design,” said Dr. Anthony S. Fauci, a leading AIDS expert who is the director of the National Institute of Allergy and Infectious Diseases.

    Asked how he felt about Thursday’s announcement, he said: “It’s obviously disappointing, but I was not surprised. I’ve been chasing these reservoirs for the last 25 years, and I know this virus has a really uncanny way of hiding itself.”

    Before the Mississippi baby, only one other person had been considered cured of H.I.V. That was an adult, Timothy Brown, previously known as the anonymous “Berlin patient,” who had a transplant of blood stem cells to treat his leukemia after his bone marrow was wiped out with drugs and radiation. The new stem cells were from a matching donor who also had a relatively rare mutation that creates blood cells lacking the surface receptor that H.I.V. uses to enter the cell.

    Then last March, a second baby, born in Long Beach, Calif., appeared to have been cured after early and aggressive treatment. But doctors had been hesitant to declare that cure as definitively as they did in Mississippi case.

    The mother in Mississippi had disappeared with her baby for several months after treatment began, and pediatricians assumed when they saw the baby again that it would be teeming with the virus. Instead, exhaustive tests found none in blood or tissue, and that remained true until several weeks ago when the virus was detected in the child’s blood during a routine office visit. By contrast, the California baby could not ethically be taken off antiretroviral drugs, which is the only sure test of whether the virus will rebound.

    When the virus enters the body, it first invades the CD4 white blood cells and makes millions of copies of itself. It then starts entering lymph cells in the gut and elsewhere and uses its RNA core to make DNA mirror images of itself that then integrate themselves into the DNA of the cell, creating the reservoir.

    After that, even if antiretroviral drugs suppress the ability of any free- floating RNA to copy itself, the DNA persists, waiting to act as a template for new RNA if the drugs are ever stopped.

    The Mississippi case stirred worldwide excitement last year when it was described in The New England Journal of Medicine. Dr. Deborah Persaud, an associate professor at Johns Hopkins Children’s Center and the lead author of the report, said at the time that it was “proof of principle that we can cure H.I.V. infection if we can replicate this case.”

    On Thursday, Dr. Persaud said the fact that the child had remained virus- free for two years was “unprecedented.” Normally, the virus rebounds in a few weeks.

    The child’s virus was identical to the mother’s, so there was no doubt that it was the virus passed at birth, not a later infection.

    Dr. Fauci said the viral load was 16,000 copies of the virus per cubic millimeter of blood. “You sometimes get a blip of 100 copies or 500 copies, but 16,000 is not a blip,” Dr. Fauci said. “That is an unequivocal relapse.”

    The child is now on triple therapy and is expected to stay that way, presumably for life unless a new route to a cure is found.

    Last March, after the existence of the Long Beach baby was revealed, a leading AIDS researcher said there were anecdotal reports of five more such cases in Canada and three in South Africa.

    It is very rare for children in wealthy countries to be born with H.I.V. because most mothers are routinely tested in pregnancy and, if infected, put on triple therapy. Only in rare cases do mothers get no testing or prenatal care at all, and those are usually homeless and mentally ill women, as was the case in Long Beach.

    NYTimes
    July 10, 2014

    http://www.nytimes.com/2014/07/11/h...child-believed-to-have-been-cured-of-hiv.html
  2. hookedonhelping
    This is great news. Imagine a world where HIV is obsolete. Earths population would begin to exponentially grow. People would be happier because they would be less worried about contracting the virus. I would probably have sex with that transgender drag queen that so totally passes for a girl. Life would be grand.

    The real question is, how much will the vaccination or medication to kill the virus cost? Two arms or just one?
To make a comment simply sign up and become a member!