A new study has revealed that the human immune system can control re-awakened HIV, suggesting that cure is possible with a "kick and kill" strategy.
UCL, the University of Oxford and the University of North Carolina's "kick and kill" strategy aims to cure HIV by stimulating the immune system with a vaccine, then re-awakening dormant HIV hiding in white blood cells with a chemical 'kick' so that the boosted immune system can identify and kill them.
While this approach is promising in theory, it was previously unclear whether the human immune system would be able to control HIV following full-blown reactivation of the virus, but the new research demonstrates that this is possible using a single patient case study.
Co-author Ravi Gupta said that the study shows that the immune system can be as powerful as the most potent combination drug cocktails, adding that they're still a long way from being able to cure HIV patients, as they still need to develop and test effective vaccines, but this study takes them one step closer by showing what type of immune responses an effective vaccine should induce.
The study looked at a single 59 year old man in London who was an 'elite controller', meaning that his immune system could control HIV for a long time without needing treatment. He had both HIV and myeloma, a cancer of the bone marrow, which produces white blood cells, including those that help to control HIV.
Co-author Deenan Pillay added that by measuring the strength of the immune system required to keep this virus under control in this rare individual, they have a better idea of the requirements for successful future treatment and they also managed to identify the specific immune cells that fought the infection. This is a single patient study, but nevertheless it is often the unusual patients who help them to understand the HIV disease process.
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Gupta noted that drugs to stimulate reactivation of dormant HIV are still imperfect and they do not know if they would be able to flush out all of the HIV from the body. Likewise, it remains to be seen whether a vaccine could enable a normal HIV patient's immune system to kill HIV with the full strength of an elite controller.
Gupta concluded that the study is a proof of principle and the results are promising, but it is unlikely to lead to a cure for at least a decade.
The study is published in Clinical Infectious Diseases.