amfAR, The Foundation for AIDS Research

A Cure for HIV/AIDS: Recent Breakthroughs and New Research Frontiers

amfAR Briefing Highlights Advances and Challenges in Cure Research

“Eradicating AIDS and finding a cure is the moonshot of our generation,” said Dr. Susan Blumenthal, Senior Policy and Medical Advisor at amfAR and Former U.S. Assistant Surgeon General, who organized and moderated an amfAR-sponsored Capitol Hill briefing on HIV cure research in Washington, D.C., this summer. 

With these words, Dr. Blumenthal brought to a close an engrossing program that had begun with renowned broadcast journalist Judy Woodruff interviewing Timothy Brown, the “Berlin Patient,” the first and only person known to be cured of HIV.  While on treatment for HIV, Brown was diagnosed with leukemia in 2006. For the stem-cell transplant he needed, his physician, Dr. Gero Hütter, was able to locate a donor among the one percent of people born with a genetic mutation making them resistant to HIV. People in this group lack the CCR5 receptor, which is the primary means by which most strains of HIV infect cells.

 495-Briefing2012-1 
Dr. Paula Cannon, Dr. Keith R. Jerome, Dr. Peter Hunt, and Dr. Robert Siliciano at the U.S. Senate. 

Following the transplant, Mr. Brown was able to stop HIV treatment without experiencing a return of his HIV and he no longer tests positive for the virus. His case provides the first proof of concept for a cure for HIV and has been the impetus for scientists and donors to begin working together toward a research goal once thought impossible. 

amfAR has been funding cure research for more than a decade, and in 2010 launched the amfAR Research Consortium on HIV Eradication (ARCHE).  As Dr. Rowena Johnston, the Foundation’s Vice President and Director of Research, said during the briefing, “We will leave no stone unturned.  The strength of the amfAR model is to bring researchers together to exchange ideas.” amfAR announced another set of ARCHE grants in June.

During the briefing a panel of four scientists discussed their research.  Three-time ARCHE grantee, Dr. Robert Siliciano of Johns Hopkins University School of Medicine, is studying ways to force latent HIV that is lying dormant in cells, to become active so that it can be targeted by antiretroviral therapy.  Dr. Siliciano has already identified several drugs that could potentially be used to reactivate latent virus and is looking for additional, more powerful options.

Dr. Keith Jerome of the Fred Hutchinson Cancer Research Center in Seattle is working to perfect a technique called gene editing, which uses an enzyme to find and remove the genetic sequence of HIV that has inserted itself into a cell’s own DNA or the protein it uses to enter the cell, leaving the cell HIV free.  “What we need,” he said, “are enzymes that cleave what we want.”

 495-Briefing2012-2 

POZ Editor in Chief and amfAR Board Member Regan Hofmann, Dr. Paula Cannon, and Timothy Brown, the “Berlin Patient” at the U.S. Senate. 

Some elements of the immune system’s response to HIV, Dr. Peter Hunt of the University of California in San Francisco, explained, lead to detrimental effects on the heart and other organs as it wears them out prematurely, leading to chronic conditions such as heart disease.  He theorizes that we need to find ways to modulate the immune system’s response to HIV so that it can both delay the onset of AIDS, as well as minimize the side effects of an overly active immune system.

Dr. Paula Cannon, of the Keck School of Medicine of the University of Southern California, is leading efforts to eliminate HIV from the body by removing the CCR5 receptor from a patient’s own stem cells.  Without this receptor the virus can no longer infect cells and dies off.   

The second half of the briefing shed light on the policy aspects of HIV/AIDS research.  Dr. Carl W. Dieffenbach, director of the Division of AIDS at the National Institute of Allergy and Infectious Diseases at the National Institutes of Health, said that proper investments in research now will pay off in the future – and could change the course of the epidemic. “Ultimately, through a vaccine and cure, we will really begin to create an AIDS-free generation,” he said. 

Regan Hofmann, editor of POZ magazine and an amfAR trustee, also urged policymakers to seize on recent scientific advancements now. “We don’t want to give false hope, but those who understand the science understand that we are there. This is our moment.”

Dr. Jerome Zack of the UCLA Center for AIDS Research and Chris Collins, amfAR’s Vice President and Director of Public Policy, discussed the issue of funding for cure research. Support for scientific research in general is threatened.  Last year, when a bipartisan Congressional committee failed to agree on a plan to achieve $1.2 trillion in deficit reductions an enforcement mechanism was triggered that will result in across-the-board spending cuts via sequestration. 

Unless it is voted down by Congress this fall, sequestration will take $300 million out of AIDS research by flat-funding the National Institutes of Health.  “If this were a business,” said Collins, “now is not the time to divest.”