Research is taking a big step towards a cure for HIV

For around 40 years, scientists around the world have been trying unsuccessfully to find a cure for HIV, but now a team of researchers from Aarhus University and Aarhus University Hospital appears to have found an important element in the equation.

That says Dr. Ole Schmeltz Søgaard, professor of translational virus research at Aarhus University, who is lead author of an innovative study just published in the journal Nature Medicine.

“This study is one of the first in humans in which we have shown a way to enhance the body’s ability to fight HIV – even while pausing today’s standard of care. We therefore see the study as an important step towards healing,” he says.

The study was conducted in close collaboration with researchers from the UK, US, Spain and Canada.

virus hidden

Although it has not been possible to find a cure or protective vaccine for HIV, today’s standard of care is very effective in keeping the disease at bay.

Today, people with HIV are offered what is called antiretroviral therapy, which suppresses the amount of virus in the blood and partially restores the immune system.

However, if standard treatment is stopped, the amount of virus in the blood rises within weeks to the same level as before standard treatment was started – regardless of whether the patient has been treated for 10 or 20 years.

Because HIV hides in the genome of some of the body’s own immune cells, and it is precisely these cells that the intervention of the research project led by Denmark is targeting.

In the study, researchers looked at the effects of two types of experimental medicine on people recently diagnosed with HIV.

Antibodies restore immunity

Study participants from Denmark and Great Britain were randomized into four groups, all of which received standard of care. Some of them were also given the drug romidepsin, which was designed to prevent the virus from hiding in the body’s immune cells, while others were given anti-HIV monoclonal antibodies, which can eliminate the infected cells and boost the immune system. One group received standard care with no experimental medicine, while the last group received a combination of standard care and both types of experimental medicine.

The results of the study are very encouraging, says Dr. Jesper Damsgaard Gunst from Aarhus University Hospital – lead author and another driving force behind the study.

“Our study shows that newly diagnosed people with HIV who receive monoclonal antibodies along with their usual HIV medications show a faster decrease in the amount of the virus after starting treatment and develop better immunity to HIV and their immune systems can partially or completely suppress the virus, when they take a break from their usual HIV medication,” he explains.

First successful clinical study

The theory behind the experiment is that the monoclonal antibodies help the immune system recognize and kill the infected cells.

In addition, the antibodies also bind in large complexes to viruses that reach the lymph nodes, where, among other things, they stimulate the ability of certain immune cells to develop immunity against HIV. In this way, the body may be able to control the spread of the virus and ‘protect’ itself from the damage caused by HIV infection.

Previous clinical trials of investigational drugs have shown no significant effects on individuals’ immunity to HIV or the immune system’s ability to suppress infection when standard treatment is discontinued.

The treatment needs to be optimized

Despite the remarkable results, there is still a long way to go before we see a cure for HIV, emphasizes Dr. Sogaard.

First, researchers need to find a way to optimize the treatment and increase its effects.

The Danish study has already attracted a lot of attention abroad and increased interest in experimental studies in people newly diagnosed with HIV infection.

Among other things, the US Department of Health and Human Services has recently allocated a large pot of money for research in this area.

In addition, the Bill and Melinda Gates Foundation and a large research network took the initiative to conduct a follow-up of the Danish study in Africa.

dr Søgaard’s research group is working on a large study to be carried out across Europe to optimize the new experimental treatment.

“We speculate that the optimized treatment will have an even stronger effect on both the virus and the participants’ immunity. By doing this, we hope to improve the immune system’s ability to permanently suppress the remaining virus.”

Behind the research results

• Type of study: Randomized clinical study.
• Partners: Departments of Infectious Diseases at University Hospitals in Aalborg, Odense and Hvidovre, Hospital Unit West, Imperial College London, King’s College London, The Rockefeller University, Howard Hughes Medical Institute, Weill Cornell Medicine, University of Nebraska at Omaha, Simon Fraser University, Labcorp -Monogram Biosciences and IrsiCaixa AIDS Research Institute.
• External funding: Danmarks Frie Forskningsfond, Regionernes Medicinpulje, Region Midtjyllands Forskningsfond, Aarhus University, National Institute of Allergy and Infectious Diseases of the National Institute of Health. Experimental drugs were provided free of charge by Rockefeller University and Celgene (BMS).
• Link to scientific article: https://www.nature.com/articles/s41591-022-02023-7