Closer to an AIDS cure: Cancer drug exposes hidden HIV

HIV can hide from the immune system for years. In a new study, a cancer drug pushed it out of hiding -- a crucial step toward creating a cure for AIDS.

The problem with HIV is that even if you eliminate it from the bloodstream, it enters a stealth mode in which it persists in white blood cells, unseen by the immune system.

There, anti-HIV drugs can't find it, but the infected person knows it's there, waiting to strike again.

This is one of the reasons that there is still no cure for AIDS. It is also why HIV patients remain on drugs for life -- to counter the disease if the virus comes out of hiding.

But a new study published in Nature shows that a cancer drug can be effective in getting the latent virus to show itself -- which, in theory, would then make it possible to target those cells with anti-HIV drugs.

The experiment, its significance and next steps

David Margolis, an HIV expert at the University of North Carolina’s Center for Infectious Diseases in Chapel Hill, and his colleagues administered a lymphoma chemotherapy drug called vorinostat to eight subjects with HIV.

The virus came out of hiding, which, in theory, could make it easier to kill. (Previous studies have been able to create this effect in the lab, but this is the first time they've bene able to achieve that result in humans.)

So far, though, the experiment just shows that it is possible to disrupt the HIV dormant phase.

As for how to handle the awakened virus ... that's the next question.

Some ideas:

  • The immune system may kill the cell.
  • Drugs could prevent the reactivated viruses from infecting healthy cells.
  • Finally, if all the dormant viruses are revived, it may be possible to eliminate the entire reservoir.

One of the next steps will be to answer that question, plus to determine the optimal dose of the cancer drug.

"We don't know how to use this drug yet, and we don't know if we have to use it all the time every day for weeks or months and months," Margolis told U.S. News. "We may just need to use it a few days here, then rest, on and off, until we get to the goal we need to get to."

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via: Nature News, Discover, U.S. News, Bloomberg BusinessWeek

illustration: Nature

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