A new approach to curing HIV is being investigated by researchers at Oxford University, UK.
Working with scientists at the University of North Carolina, USA, Dr Ravi Gupta and the team are focusing on a strategy they describe as "kick and kill". This involves using a vaccine to stimulate the immune system, then chemically re-activating dormant HIV hiding in white blood cells so the boosted immune system can identify and destroy them.
The experts explain that the human immune system can manage large bursts of HIV activity, but it is unclear whether it could control HIV following full-blown virus reactivation.
So the team carried out a single patient case study of a 59 year old man in London whose immune system could control HIV for a long time without needing treatment. This type of patient, known as an "elite controller", constitutes 0.3% of HIV patients.
He also had the bone marrow cancer myeloma, which was treated by complete removal of his bone marrow and replacement with his own cells. During this process his immune system was severely impaired so the HIV reactivated and replicated.
Blood levels of the virus rose from fewer than 50 copies per millilitre to 28,000 copies per ml. But when immune function returned after about two weeks, levels fell rapidly, and returned to 50 copies per ml within six weeks.
The researchers say in the journal Clinical Infectious Diseases that the patient’s immune system reduced HIV levels at a similar rate to the most powerful treatments available.
Co-author Dr Ravi Gupta said: "Our study shows that the immune system can be as powerful as the most potent combination drug cocktails. This study shows us what type of immune responses an effective vaccine should induce."
Smith, N. M. G. et al. Proof-of-principle for immune control of global HIV-1 reactivation in vivo. Clinical Infectious Diseases 16 March 2015 doi: 10.1093/cid/civ219
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