Researchers Continue to Pave the Way for an HIV Cure

Jeff Taylor, a member of the Community Advisory Board of the Care Collaboratory, a National Institutes of Health-funded research center at the University of North Carolina

Today the world is closer to a cure for HIV/AIDS than ever before. But what does that really mean? A Brown Bag Lunch Webinar was held by the Black AIDS Institute in June 2017 to answer that question and give an overview of how close researchers are to putting an end to the HIV/AIDS epidemic once and for all.

When it comes to developing a cure, the Holy Grail would be a situation in which a person living with HIV would no longer have to take medication, would experience no symptoms, would not have to worry about progressive damage to the immune system and would have no risk of transmitting HIV.

A cure would be a game changer, not only saving lives but also eliminating the burden of taking medication and the expense of being ill. Researchers are exploring a number of ways to make that happen.

On the Hunt for a Cure

One promising approach that is being studied is what's known as the "kick and kill" approach, explained Jeff Taylor, a member of the Community Advisory Board of the Collaboratory of AIDS Researchers for Eradication, a National Institutes of Health-funded research center at the University of North Carolina. With this method, the goal is to use a drug called a latency reversing agent to flush out pockets of HIV that lie dormant in the body. Ideally, when the drug stimulates an HIV-infected cell, that cell would begin to produce more of the virus, which would then be wiped out by the body's immune system.

However, there are some challenges related to the kick-and-kill approach. Many of the medications used to kick or shock the HIV-infected cells have painful side effects. In fact, many of the latency reversing agents are cancer drugs, which are known for being difficult to tolerate. There is also the possibility that not all of the infected cells will be found.

Another area where there is optimism about an eventual cure is vaccines, which are considered the "gold standard of eradicating epidemic viruses," said Cindra Feuer, a senior program manager with AVAC and a presenter of the webinar. While it may seem to be taking a long time to find an HIV/AIDS vaccine, Feuer pointed out that it took 105 years to discover a vaccine for typhoid and 47 years to discover a vaccine for polio.

Preventive vaccines would be for someone who does not have HIV, and would prevent that person from getting HIV. The vaccine itself would be made up of a substance that mimics HIV and would cause the body's immune system to respond. That way, if the person who received the vaccine were ever exposed to HIV later, the immune system would fight it.

Unlike preventive vaccines, therapeutic vaccines would be for those who already have HIV, and they would help control the progression of HIV in the body.

Challenges in Vaccine Science

Despite the many scientific advances related to developing a vaccine for HIV, there are still a number of challenges that must be overcome, Feuer said.

· There are multiple ways that HIV is transmitted, so the vaccine would have to be able to protect against all modes of transmission.

· HIV kills the very immune cells that the vaccine would use to defend the body against the virus.

· The virus makes copies of itself and mutates, making it unrecognizable to the body's immune system.

· Mutation leads to different subtypes of HIV throughout the world.

· There is no example of a person who has been able to eliminate HIV using his or her immune system.

The good news is that there have been six large-scale phase 3 studies involving HIV vaccines. One of them, conducted in 2009 in Thailand, yielded modest results, showing a 31 percent reduced risk of getting HIV and proving that a vaccine is possible, Feuer said.

Small- and large-scale studies continue to take place, and researchers are working to make an effective vaccine a reality.

With that in mind, Feuer said there is every reason to be hopeful. "We're in a really promising era of vaccine science," she said.

Tamara E. Holmes is a Washington, D.C.-based journalist who writes about health, wealth and personal growth.