Controlling HIV replication without the need of
life-long antiretroviral therapy (ART) is the next frontier scientists are
addressing. Researchers involved in the fields of HIV reservoirs and
eradication have just released the preliminary program of a workshop they will
organize later this year, where scientific breakthroughs are expected.
Fifteen years ago, when ART was discovered, a renewed optimism for a cure
gained several scientists who predicted that 3 years of undetectable viremia
would be able to get rid of HIV. In 1997, a reservoir of latently-infected cells
was demonstrated in patients, which is established very early at acute
infection. As these are resting cells which do not usually produce viral
particles, they are not destroyed by the immune system and are inaccessible to
ART. They also take part to the memory of the immune system, are life-long and
would actually need more than 60 years of undetectable viremia to eventually be
replaced by uninfected cells...
Despite dramatic decreases in morbidity and mortality with ART, new problems
have emerged and life-long ART cannot be considered as the final response to
the HIV pandemic. Patient’s adherence to treatment is variable, with possible
selection of resistant strains. Toxicities accumulate with time, in particular
of the metabolic type with an increased risk of cardiovascular events,
osteopenia, lipodystrophy. Disease evolution is not completely stopped and
slowly progressive neurocognitive dysfunction is found in some patients.
Persistent chronic inflammation is another proof that the damages inflicted to
the immune system and lymphoid organs are not totally reversed. Finally,
universal access to ART is a major financial problem and the pandemic remains
highly active with more than 7,000 daily new cases of HIV infection worldwide.
To address the issue of a cure, researchers have to set up in vitro and in vivo
(animal) models of HIV persistence, define the virological and immunological
mechanisms involved in HIV persistence, and discover new drugs acting
differently than ART.
Their first objective is to induce a “HIV functional cure”, a situation where
the virus would not be replicating and would not cause harm in the absence
of ART. This condition naturally exists in a tiny proportion of patients,
called ‘elite controllers’. These patients exhibit both low levels of HIV
reservoirs and strong anti-HIV immune responses. The ultimate objective of
researchers is to obtain a “HIV sterilizing cure”, where the virus is
eliminated from the body. Several drugs are already in the pipeline to “flush
out” the HIV reservoirs.
The “HIV Persistence, Reservoirs & Eradication Strategies Workshop” will
gather all the international community of researchers working on a HIV cure and
help define the right scientific path to success.
About the workshop:
International Workshop on HIV Persistence, Reservoirs & Eradication
Strategies, December 6-9, 2011, Sin Maarten.
Contact:
Alain Lafeuillade
Informed Horizons, LLC
860 Montreal Road, Suite 2
Tucker GA 30084, USA
Ph: +1 770 573 3020
