In pursuit of a cure
As a young man moving to New York City in 1990, I experienced firsthand the human devastation inflicted by AIDS at the height of the epidemic. In the early 1990s, I would go to as many funerals as I would movies. So for me this epidemic is personal.
The progress we have made since those terrible days in developing effective antiretroviral drugs to treat HIV is a tribute to the power and potential of medical research, and I think the significance of this achievement is often underappreciated. I’m proud to say that my organisation — amfAR — supported the early studies that laid the groundwork for the development of four of the six classes of antiretroviral drugs in use today. With good adherence, these drugs can confer a relatively normal lifespan on someone diagnosed with HIV in their 20s or 30s.
As we all know, we have a long way to go before we can say that this epidemic is under control. But I am excited about some of the research amfAR is supporting today and its potential for ultimately delivering a cure for HIV. Let me briefly describe three of these studies.
While current antiretroviral therapy (ART) can reduce active virus growth to undetectable levels, a stable reservoir of virus remains invulnerable to attack by these drugs. One strategy to overcome this latent reservoir is to activate the latent cells, making the virus susceptible to ART. amfAR recently funded some research that found that disulfiram, a drug used to treat alcoholism, could activate latent HIV in the test tube. We are now supporting Dr. Julian Elliott of Monash University in Melbourne, Australia, and Dr. Steven Deeks of the University of California, San Francisco, who aim to determine whether this concept could be effective in patients.
Dr. Timothy Henrich of Harvard Medical School and Brigham and Women’s Hospital is studying two HIV-positive individuals who had been on long-term ART when they developed lymphomas. To treat their cancer, both underwent typical stem-cell transplants from donors who had been selected only for tissue-type match. But Dr. Henrich found something extraordinary. Not only were the patients cured of their cancer, he could find no evidence of HIV infection. For the moment, they both remain on ART. But with amfAR funding, Dr. Henrich will interrupt their ART and search for HIV in their blood and other tissues. He will also assess the size of their HIV reservoir if any latent virus is uncovered.
amfAR is also supporting the work of Dr. Deborah Persaud of Johns Hopkins and Dr. Katherine Luzuriaga of the University of Massachusetts. They will determine if it is possible to cure an HIV infection with ART alone in children in whom ART was started soon after birth and continued for an average of 15 years. Drs. Persaud and Luzuriaga have a group of five such children with no detectable HIV, who remain HIV antibody negative. The researchers will use highly sophisticated tests to search for active and latent virus.
These three studies are being supported through a collaborative initiative we launched in 2010, called the amfAR Research Consortium on HIV Eradication, or ARCHE. It’s our belief that cure-focused research will progress much more quickly if scientists work together, and that is what ARCHE is designed to do.
Ultimately, our success will be dependent on two key ingredients: financial resources and political will. Without sustained support for AIDS research, the epidemic will likely grind on, undefeated, for generations to come.
Kevin Robert Frost joined amfAR, The Foundation for AIDS Research, in September 1994 and has served as the Chief Executive Officer since March 2007. In February 2010, Mr. Frost was appointed to the Presidential Advisory Committee on HIV/AIDS, which is charged with providing guidance and recommendations to the U.S. Secretary of Health and Human Services on HIV/AIDS prevention and research.
For further information on new research, see AVERT's science section.
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All opinions expressed in 'Reflections on the Epidemic' do not necessarily represent those of AVERT.