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Clinical posts from members and guests of the Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM) from various international medical and scientific conferences on HIV, AIDS, viral hepatitis, and sexual health.
HIV cure research: current strategies and challenges
I attended the talk by Prof Sharon Lewin this afternoon titled ‘HIV cure research: current strategies and challenges’
Sharon started off by saying that sustained remission off ART is achievable. Some examples of this are the Visconti cohort and the Mississippi baby.
Early ART has a greater impact in limiting persistence of the HIV reservoir than later treatment (as found by Ananworanich and Chomont , Curr Opin HIV AIDS 2015). However, post treatment control is a rarity following ART in acute HIV infection and biomarkers to predict cure/remission are required (e.g. in the Swiss HIV cohort study, HIV DNA predicted time to rebound).
Sharon touched on latency reversing agents now in clinical trials e.g. HDAC inhibitors , TLR agonists, activators of NF-kB and others such as disulfiram.
Sharon said that activation of latent HIV was possible in vivo with HDAC inhibitors, disulfiram and TLR7 agoinsts but there is a need for more potent, less toxic and more specific agents.
Combination of agents (e.g. HDAC inhibitors and smac mimetics) as well as modulating immunity via vaccination or immune checkpoint inhibition are also in the pipeline and gene therapy is also an avenue to be explored.
After this talk I felt very inspired about the work Sharon and other researchers searching for a HIV cure are doing!