Hope for a HIV Cure

Hope for a HIV Cure

http:www.nytimes.com/2011/11/29/health/new-hope-of-a-cure-for-hiv.html?_r=1&ref=sc…

Scientists have put a cure for HIV on the back burner while concentrating on prevention and treatment. Now many patients are able to take daily antiviral pills for HIV. With the recent success of two patients, the hunt for a cure has been re-energized. The two main approaches are a sterilizing cure where the HIV is eradicated and a functional cure where the virus is not completely eliminated but the patient would remain healthy without antiviral drugs. The “Berlin” patient, who was HIV positive, received two bone marrow transplants for leukemia from a donor who was resistant to HIV because the donor lacked the protein CCR5 that the HIV virus uses as an entry point on the immune cells. 1 percent of Northern Europeans are naturally resistant. The Berlin patient has been HIV free for four years. Scientists are trying to modify a patient’s own immune cells to be resistant by eliminating the CCR5 protein through gene therapy. The “Trenton” patient had white blood cells removed and treated to induce the cells to produce proteins called zinc-finger nucleases that disrupt the CCR5 gene, then these cells were infused back into the patient. Other patients did not do as well as the Trenton patient with this treatment. However, the Trenton patient had an inherited mutation in one of his two CCR5 genes.

“Any approach that is going to require genetic engineering on a patient-by-patient basis is just utterly unrealistic in terms of the global epidemic,” said Dr. Robert Siliciano, John Hopkins professor of medicine. Other detractors say a functional cure would not offer much beyond the existing antiviral drug therapy. Both the sterilizing and functional approach to the cure has many challenges, but millions of dollars are being spent on developing a cure and scientists are encouraged by these recent results.