By Tanya Harrington and Kat Pooprasert
Recently, the Sunday Times reported that a 44-year old British man was part of a drug therapy trial, claiming that its purpose was to “track down and destroy HIV in every part of the body — including in the dormant cells that evade current treatments.” It was also reported that the man’s viral load, that is, the markers of HIV present in the bloodstream, was undetectable.
Of course, this is good news – the availability and use of various kinds of treatment trials for HIV is a source of hope and development in spite of such a serious illness. However, as pointed out by Fergus Walsh of the BBC, there is more than one thing wrong with using this information as fuel for an exciting headline. The first of these reasons is that having a lowered or undetectable viral load is no longer so uncommon – regardless of whether or not they are also taking part in clinical trials, people with HIV also often take antiretroviral medication, which keeps the HIV virus dormant and therefore renders it undetectable anyway.
The RIVERS trial (Research in Viral Eradication of HIV Reservoirs) aims to get rid of the virus completely from the body. Currently, 39 out of 50 patients have been recruited to the trial. All participants will receive ART but half will also be given a drug which forces the virus to emerge from hiding places in the body. These patients will also be given two vaccines which is aimed at boosting the immune system so that it is able to attack HIV-infected cells. Results from the trial are expected in 2018 and will mainly be obtained from detailed analysis of blood samples from volunteers.
The trial is conducted by a consortium of research teams which are in a partnership since six years ago. The participating universities are Imperial and King’s College, London, Oxford and Cambridge Universities and University College London.
Mark Samuels, the managing director of the National Institute for Health Research Office for Clinical Research Infrastructure said that “this is an unprecedented collaboration and to get to clinical trials in six years shows remarkable progress.”
All of the trial volunteers are newly infected HIV patients, meaning they will only have a small viral reservoir and their immune system will not have been repeatedly damaged by the virus. Thus, even if the trial is a success, there still needs to be caution in interpreting the results, as it may not work in long-standing HIV patients.
Dr. Michael Brady, the medical director of Terrence Higgins Trust said that “in test tubes, it has been shown that you can drive the virus out of dormant cells, but we will have to wait and see whether it works in patients. Even if it works we can’t talk about a cure for everyone and there would need to be bigger trials”.
As of now, only one person appears to have been cured of HIV infection. The patient, Timothy Ray Brown, received a bone marrow transplant from a donor with natural immunity to the virus.
In other developments, earlier this year, there has been gene editing trials in California involving 80 HIV patients, but results are still pending.
All in all, despite further research, the idea of a cure to HIV is still premature.