Unc Hiv Cure Center Awarded $262 Million Over The Next 5 Years
The National Institutes of Health will award $53 million annually to 10 research organizations over the next five years to continue working toward curative therapies for HIV. The Collaboratory of AIDS Researchers for Eradication , led at the UNC HIV Cure Center by David Margolis, MD, is one of two programs to have received funds for all three five-year grant cycles since 2011.
CHAPEL HILL, NC The National Institutes of Health has awarded approximately $53 million in annual funding over the next five years to 10 research organizations in a continued effort to find a cure for HIV. The new awards for the Martin Delaney Collaboratories for HIV Cure Research program, initiated in 2011, further expand the initiatives 2016 renewal from six institutions to 10, and represent a funding increase of approximately 75 percent. Additionally, one of the new grants is focused specifically on HIV cure research in infants and children.
The Collaboratory of AIDS Researchers for Eradication , which will receive $5.2 million for each of the next five years, was one of the two original collaboratory programs funded since the beginning, along with UC San Francisco. CARE is led by David Margolis, MD, professor of medicine at the UNC School of Medicine, director of the UNC HIV Cure Center.
Read more about the collaboratory and the organizations funded this round at the NIAID website.
UNC Contact: 919-923-0959
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Recovery Of The Berlin Patient
Timothy Ray Brown, who was known as the “Berlin patient,” was given a diagnosis of HIV in 1995. He took medication to suppress the viral load in his blood. That is, he took medication to decrease the amount of the virus in his blood. However, ten years later he was diagnosed with acute myeloid leukemia . After four counts of chemotherapy, the cancer went into remission. Yet, it came back and he needed a stem cell transplant.
The treatment team he was under decided that if they could get a donor with the mutation of the CCR5 delta gene, it might help get rid of the HIV infection. It was reported that three months after the transplant, HIV was no longer detectable in his blood despite the fact that he had stopped taking antivirals to treat HIV. Today, it is reported that this person is still free of antivirals and takes pre-exposure prophylaxis every day. This is to say he does not have HIV.
Timothy Ray Brown
“Be compassionate to all your patients and if you can , try develop a personal relationship with your patients. There is no room for stigma.”
â Timothy Ray Brown
The stem cell transplant treatment is a very intense therapy involving chemotherapy, so it really isn’t seen as a good treatment option for most people infected with HIV. Some people think that the case with Brown was an anomaly brought on by intense cancer treatment and holds no promise of a cure.
Treatment Reduces The Amount Of Hiv In The Blood
- The amount of HIV in the blood is called viral load.
- Taking your HIV medicine as prescribed will help keep your viral load low and your CD4 cell count high.
- HIV medicine can make the viral load very low . Viral suppression is defined as having less than 200 copies of HIV per milliliter of blood.
- HIV medicine can make the viral load so low that a test cant detect it .
- If your viral load goes down after starting HIV treatment, that means treatment is working. Continue to take your medicine as prescribed.
- If you skip your medications, even now and then, you are giving HIV the chance to multiply rapidly. This could weaken your immune system, and you could become sick.
- Getting and keeping an undetectable viral load is the best way to stay healthy and protect others.
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How Far Are We From A Cure For Hiv
It’s been decades since the discovery of the human immunodeficiency virus . Ever since its discovery, researchers have been working tirelessly to figure out the characteristics and inner workings of the virus to find a cure.
A definite, traditional cure has not yet been established, even though researchers and scientists consider two specific, yet expansive, methods as cures.
Functional vs. Sterilising
Researchers, scientists and doctors are currently working on these procedures, which are classified as “functional” and “sterilising” cures.
Professor Caroline Tiemessen, head of cell biology for the Centre for HIV and Sexually Transmitted Infections at the National Institute of Communicable Diseases told Health24 that we are still a long way off from a complete cure.
Achieving HIV remission may be possible for some, but we need a better understanding of who would benefit. It is clear that early treatment is not enough for most, and additional interventions need to be found.
With regards to there ever being a cure for HIV and Aids, we would first need to define the HIV cure complete eradication like the Berlin Patient versus HIV remission, as in a functional cure, which is sustained control of the virus to undetectable levels without antiretroviral drugs.
Achieving HIV remission is the more feasible option, whereas achieving a complete cure is a major challenge, said Tiemessen.
Complexities of the sterilising cure
SA has done exceptionally well
R75 per month
Could This Cure Mean The End Of The Hiv Epidemic
Unfortunately, there are societal and personal obstacles outside of the literal cure being scaled up and made available.
The HIV epidemic in North America continues to have worse outcomes across racial lines, and overlaps with a severe opioids epidemic in socio-economically worse off areas.
While Black people make up 13% of the US population, they are 43% of HIV-related deaths in 2018. These entwined factors create a difficulty of treatment for medical care is expensive, inaccessible and stigma continues to exist about having HIV in the first place.
Currently, the UK have made it possible for people living with HIV to access the COVID vaccine without declaring their medical status.
Dr Errol Fields, Johns Hopkins University School of Medicine, said: The racial disparities that so rapidly emerged with COVID-19 are a reminder that until these inequities are addressed, disparities in HIV and COVID-19 outcomes will persist and ending the HIV epidemic will remain elusive.
Across the world, HIV is a huge problem for women and girls who have to trade themselves sexually in exchange for access to resources like food, water and medicine.;
While many infectious diseases like HIV/AIDS do not have a direct link to the environment in their transmission patterns or vectors, disasters such as drought can still have a significant influence on the social conditions that shape and enhance vulnerabilities, said the researchers.
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How Does Hiv Infect Humans
The way the HIV virus spreads is that once it enters the human body, the virus latches on to the CCR5 receptor of the white blood cell and spreads. It was discovered around 20 years ago that 10% of people in Europe and the United States have a mutation of the CCR5 receptor delta 32 which makes it so that the receptor is not able to work and HIV cannot enter the white blood cell.
Basic Science And Social Support
Moxie is unlikely to be the last women-only study. At the pre-conference workshop, Dr Krista Dong of the Ragon Institute outlined plans for a study with young women who seroconverted whilst in the FRESH cohort in the hyper-endemic region of KwaZulu-Natal, South Africa. FRESH is already a remarkable study that provides a model for how basic science research can be combined with a social support programme.
The FRESH cohort is made up of young, socioeconomically disadvantaged women at high risk of HIV. The scientific aim is to diagnose acute HIV infection in young women, allowing the investigation of the earliest immunological and virological events after HIV infection in order to inform vaccine and cure research.
“The aim is to diagnose acute HIV infection in young women, allowing the investigation of the earliest immunological and virological events after infection.”
So as to identify women as soon after HIV infection as possible, the participants are asked to attend twice weekly and be tested for HIV RNA. So as to make this attendance valuable for the women themselves, Dong and colleagues developed a social programme focused on life-skills and job-skills needed to enter and succeed in the workforce, with training delivered at the time of the study visit. Topics covered include women’s health, HIV prevention, gender-based violence, relationships, stress management, self-esteem, and communication.
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The Ccr5 Delta 32 Mutation
This type of mutation is found in people of Northern European descent. Yet, it only works in the one percent who inherited it from both parents. These lucky few who inherited this from both parents are referred to as homozygotes. These people are one hundred times less likely to come down with HIV than someone without the mutation if they have exposure to HIV.
Antibodies To The Rescue
Perhaps the most promising avenue of all in HIV research, McNamara says, is that of broadly neutralizing antibodies. These naturally occur in the immune systems of asmall fraction of HIV patients whose infection never progresses to AIDS. Researchers are studying how to harness them to treat other patients.
HIV is mutation-prone, which allows it to thwart the immune system and retroviral drugs that are made to target specific versions of the virus. For most patients with HIV, this means their immune system is always in hyperdrive, struggling to ward off a moving target. Its a nonstop war between the virus and the immune system, McNamara says.
But some patients have a special type of antibody that is continually effective. When it comes to broadly neutralizing antibodies, the virus is never able to win, McNamara says. The antibodies have it check-mated.
Though latent reservoirs are still an obstacle to them, broadly neutralizing antibodies show a lot of promise when it comes to keeping the virus at bay in particular, ensuring that the infection never progresses to AIDS and that its transmission risk is low. Some researchers are examining how they can be used both to treat and prevent HIV, while others are looking at how a combination of neutralizing and non-neutralizing antibodies may even have some effectiveness against latent cells.
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Induce And Reduce: Our Approach To Hiv Cure
HIV is a sneaky virus that can persist in a small population of cells even while its spread to new cells is being suppressed by ARVs. Unless we can find a way to expose hidden HIV and selectively target these cells, well continue to require chronic treatments to keep the virus at bay. Thats why cure research currently underway by Qura Therapeutics and ViiV Healthcare targets these pockets of virus through the concept of induce and reduce.
This strategy is first focused on driving HIV hidden in human immune cells to make viral proteins that allow the cells with HIV to be recognised . Once cells harbouring HIV are exposed, drugs can then tag these reservoir cells for elimination by the host immune system . The Induce and Reduce agents will all be given while people are on suppressive ARV therapy to protect healthy cells from the virus. While it may sound straight forward, it has been a major challenge to reactivate the virus in animals or people in an effective and safe way.
The research required to develop an HIV cure is complex and requires a commitment to the long-term. As we look ahead to the future, were optimistic that the initial steps weve taken towards establishing our approach to HIV cure will move from the laboratory into clinical studies in people, big steps in the long journey to finding a cure for HIV. It is our lifes work to end the HIV epidemic, and we will be here until HIV isnt.
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How It Could Be Done For Others
Brown and Castillejos cures, as transplants, were so-called allogenic, meaning that the HIV-resistant cells came from another person. Better would be autogenic transplants, in which immune system cells are taken from a person with HIV, genetically altered in the lab dish to make them resistant to HIV, and then re-introduced. This type of procedure by treatment advocate Matt Sharp, who underwent one.
The repertoire of gene therapies is not restricted to CCR5 deletion. Gene therapy is immensely versatile, and could be used in a number of ways.
Instead of using gene therapy to make cells resistant to HIV, it could directly repair defective genes in cells by means of cut-and-paste technology such as CRISPR/Cas9. This is already being used in trials for some genetic conditions such as cystic fibrosis and sickle-cell anaemia. Given that HIV-infected cells are also defective in the sense that they contain lengths of foreign DNA that shouldnt be there, they are amenable to the same molecular editing. Early trials have produced promising results but the challenge, as it has been in a lot of gene therapy, is to ensure that the cells containing DNA are almost entirely eliminated.
“Timothy Ray Brown and Adam Castillejo were both given bone marrow transplants from donors whose T-cells lacked the gene for the CCR5 receptor.”
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Researching An Hiv Cure: The Main Approaches
Although the stem cell approach has had some success in the past, its very dangerous for the patient. It would only be considered a viable option, if the person needed a stem cell transplant to treat another more deadly condition, such as very advanced leukaemia which, unlike HIV, doesnt have as many other safe and effective treatment options available.
While there is promising research being carried out in these areas, there is no viable cure on the horizon.
Cure For Aids Could Possibly Be Found In South Africa
Early clinical trials in South Africa have given researchers new hope of developing a vaccine for AIDS and a host of other HIV prevention methods are also being tested in South Africa
Scientists fighting the HIV/AIDS epidemic have already revolutionised the safe sex paradigm with advances;in Biomedical technology but are still a long way from creating the ultimate weapon an AIDS vaccine.
They are confident, however, that it can be done and the chances are that this Holy Grail of medicine will be found right here in South Africa.
South Africa is a;leader in HIV research
South Africa is home to the largest population of people living with HIV in the world. What really distinguishes SA, however, are the strides the nation is making against the epidemic, says Glenda Gray president of the SA Medical Research Council.
One of these strides, which has researchers optimistic about the future, was the success of a phase 1 trial called HVTN 097 to evaluate the RV144 vaccine regimen in South Africa, the results of which were presented at the HIV Research for Prevention conference in Cape Town last week. The;venue for the conference was chosen because of South Africas leadership in HIV research and prevention. Many of the most important clinical trials and studies that have advanced the global AIDS response have been hosted, supported, designed and led by this country.
Other HIV prevention methods showcased at the conference include:
PrEP
Microbicides
Combination Prevention
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Origins Of The Ccr5 Delta 32 Mutation
This mutation existed thousands of years before HIV came into existence. The exact origins of the mutation are still highly debated and really unknown. There is a general theory that, thousands of years ago, there was a virus or a series of viruses that killed off anyone who didn’t have the mutation. So, the people who had the mutation were the only ones who survived and procreated, causing even more people to have the mutation. It was suggested that it was the Bubonic Plague. However, that was a bacterial infection. It could not have been Smallpox because that didn’t develop until the 1600s.
There were two researchers who tried to explain which epidemics caused the mutation to flourish and why it is so common in Scandinavia and Europe but not near the Mediterranean. Their theory is that, in the Middle Ages, there were plagues in Europe from 1340 to 1660 and these plagues caused the mutation to become more abundant. Their belief is that these plagues consisted of reoccurring viral infections that were lethal and used the CCR5 receptor to get access into the white blood cells. These outbreaks reoccurred in Hungary, Poland, Russia, Sweden, and also Denmark and continued through the 1700s. However, some disagree with this and think that these plagues were bacterial and not viral.
A Cure For Hiv Past Research Of The Ccr5 Delta 32 Mutation
My game plan is to research, condense my findings, and translate it into everyday language for busy people.
With as devastating a disease as HIV, will there ever be a cure? Research is being done in regard to finding a cure for HIV infections, which affect the lives of millions, and which can cause death and leave people often marginalized, disenfranchised, and isolated due to the stigma against the disease.
HIV can be controlled by using antivirals. Antivirals are medications used to decrease the amount of AIDS/HIV in peoples’ blood. So, someone with this disease can live a long and functional life. However, not everyone has access to the antivirals, and HIV can cause death if it is not treated. There has been some evidence that a genetic mutation in the white blood cell might hold some answers as to developing a cure for this disease.
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