By Daniel J. DeNoon
WebMD Health News
Reviewed by Louise Chang, MD
It's a stunning turnaround. Hopes for an AIDS cure were dashed early in the epidemic when researchers realized that the AIDS virus can lurk inside dormant cells to avoid elimination by powerful anti-HIV drugs.
Barre-Sinoussi and other leading AIDS researchers today open a two-day conference, "Towards an AIDS Cure," in advance of next week's International AIDS Conference in Washington, D.C. It's the most optimistic opening of an AIDS conference since the discovery that a combination of HIV drugs could keep a person from developing AIDS.
Now these researchers want to go a step further. They believe it's possible to totally eradicate HIV from the body -- or, failing that, to achieve a "functional cure" that will keep a person AIDS-free without the need for HIV drugs despite lingering HIV in the body.
Barre-Sinoussi is president-elect of the International AIDS Society, sponsor of the International AIDS Conferences, and the major partner in the new AIDS cure alliance.
Co-led by Barre-Sinoussi and Steven G. Deeks, MD, of the University of California, San Francisco, a group of 34 top AIDS researchers and clinicians has laid out a global scientific strategy for curing AIDS.
Key Steps and Priorities
This strategy stresses six key steps that must be taken:
- Establish large, multinational collaborations between experts in a wide range of fields.
- Basic scientists should work side by side with clinicians, quickly translating what's learned in the lab into human studies and translating what's learned in human studies back to the lab.
- Finding the best animal models for exploring an AIDS cure. For example, researchers have recently learned to model treatment with human anti-HIV drugs in macaque monkeys infected with SIV, the simian version of HIV.
- Mentor and support young researchers with new ideas.
- Address difficult regulatory issues surrounding drug testing. AIDS cure research will need to test new drugs -- some with a high likelihood of toxicity -- in HIV-infected patients who are doing well on their current drug regimens.
- Get strong community support by ensuring that patients and the communities are fully informed about the risks and benefits of cure research.
There are seven priorities for this research:
- Figure out exactly how HIV persists in the body despite effective anti-HIV treatment.
- Figure out exactly where in the body HIV is hiding.
- Figure out why the immune systems of people being treated with anti-HIV drugs are activated, and what this means for HIV persistence.
- Figure out the immune mechanisms in "elite controllers" that control HIV infection but allow it to persist.
- Develop tests to measure persistent HIV infection.
- Develop and test strategies to eliminate latent HIV infection.
- Develop and test strategies to enhance the ability of the immune system to control HIV infection.
It's not a pipe dream. Eleven HIV cure clinical trials already are under way. Three others are starting soon.
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