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Why talk of a cure for HIV is premature’ – BBC News

Beware of headlines which suggest scientists are “on the brink of HIV cure”, or “HIV cure close”.

They grab the attention – which is of course the aim of a headline – but talk of a breakthrough is premature.

The Sunday Times reported that a British man with HIV was receiving a prototype therapy designed to eradicate the virus from his body.

Early tests from the clinical trial have apparently shown no signs of the virus in his blood.

That may sound astonishing unless you know that conventional antiretroviral therapy (ART) – which the patient was also taking – already reduces HIV to undetectable levels.

Viral load

Sarah Fidler, Prof of HIV Medicine at Imperial College London, who is leading the trial, told me: “All the participants are taking antiretrovirals and so will have an undetectable viral load, which shows the great success of current treatment.”

It does indeed. HIV medication has turned the infection from a death sentence to a chronic, manageable condition, which is remarkable.

The limitation of ART is that it cannot eliminate HIV.

The virus remains dormant in some immune cells and will start replicating if patients stop taking their medication.

That’s why antiretrovirals must be taken for life.

The RIVERS trial (sic) – which stands for Research in Viral Eradication of HIV Reservoirs – is trying to rid the virus completely from the body.

‘Kick and kill’

So far, 39 out of a total of 50 patients have been recruited to the trial. All will receive ART but half will also be given a drug which forces the virus to emerge from hiding places in the body. These chosen patients will also receive two vaccines which aim to boost the immune system so that it can attack HIV-infected cells.

The strategy is called “kick and kill”.

The anonymous patient quoted in the newspaper article is simply the first of the participants to have completed the kick and kill treatment.

No results are expected until 2018.

The trial is being conducted by a consortium of research teams at Imperial and King’s College, London, Oxford and Cambridge Universities and University College London.

The partnership began six years ago, and set out to search for a cure for HIV.

Mark Samuels, managing director of the National Institute for Health Research Office for Clinical Research Infra­structure, which set up the medical consortium, told me: “This is an unprecedented collaboration and to get to clinical trials in six years shows remarkable progress.”

So how will the researchers know whether their trial has been a success?

This will take some time and involve detailed analysis of blood samples from volunteers.

Viral reservoir

John Frater, Prof of Infectious Disease at Oxford University, told me: “We will carry out a very targeted genetic test to look for HIV lying dormant within immune cells.”

All the trial volunteers are newly infected HIV patients which means they will have a small viral reservoir and their immune system will not have been repeatedly damaged by the virus.

If it is possible to cure HIV, these patients represent the easiest target.

But even if the trial is a complete success, caution will be required in interpreting the results because it may not work in long-standing HIV patients.

Dr Michael Brady, medical director Terrence Higgins Trust told me: “In test tubes it has been shown that you can drive the virus out of dormant cells, but we will have to wait and see whether it works in patients.

“Even if it works we can’t talk about a cure for everyone and there would need to be bigger trials.”

To date, only one person appears to have been cured of HIV infection.

Timothy Ray Brown, the so-called Berlin patient, received a bone marrow transplant from a donor with natural immunity to the virus.

However, bone marrow transplants are potentially dangerous and so not an approach that is recommended.

Earlier this year I reported on a gene editing trial in California involving 80 HIV patients.

They had immune cells in their blood removed and editing to try to mimic the gene mutation which gives some people a natural immunity to HIV.

One of the volunteers, Matt Chappell, has been off all antiretroviral medication for two years since having his immune cells gene edited.

These were small trials so caution is needed before reading too much into the results, but they are nonetheless promising.

The British trial is taking a different approach but with the same aim – trying to free patients from the need to take daily medication.

But talk of cures is premature.

3 October, 2016

Original article

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CHERUB response to the recent media coverage regarding the RIVER trial

In response to the recent attention in the media regarding the RIVER study run by the UK CHERUB collaboration, we would like to clarify the following.

Our study will report in 2018, and until then we will not know if the intervention has had an effect. We do know from our first participant that the intervention was well tolerated. This is the first time that this combination has been given in a clinical trial, which we hope will be the first of many collaborations exploring HIV cure between our five universities and NHS hospital trusts, supported by the NIHR.

An important clarification is that all participants involved in the study will be expected to have no HIV in their blood because they are receiving antiretroviral therapy – these are the standard drugs we use to treat HIV. This does not mean they have been cured as some headlines have suggested. This does mean that their immune systems will recover and that they will not transmit the virus. We look forward to reviewing the final results of this ground-breaking study, but until then should emphasise that we cannot yet state whether any individual has responded to the intervention or been cured.

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HEATHER meeting 22nd September 2016

heather-logo

The HEATHER research team would like to invite you to attend a feedback meeting.

HEATHER (HIV reservoir targeting with Early Antiretroviral Therapy) is a study that has been set up to try and understand what happens to HIV when patients start treatment early after infection and remain on treatment for a long period of time.

This meeting will be an opportunity to show some of the laboratory results from the samples that have kindly been donated by the study participants as well as the research that is involved in this study. There will also be a chance to chat with the scientists and researchers who are working on this exciting and unique study.

When: 22 SEPTEMBER 2016, 6-7.30pm

Where: Room G64 and G65A – Medical School St Mary’s Campus.
The medical school is building number 5, and the main entrance is opposite the Cambridge Wing entrance. Please click on the link for directions:
https://www.imperial.ac.uk/visit/campuses/st-marys/

RSVP: Please confirm your attendance by 17 SEPTEMBER 2016

Snacks and drinks will be provided

We hope to see you there.

The HEATHER research team

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5th CHERUB Scientific Workshop Brochure

The fifth annual CHERUB Scientific Workshop took place on Friday 4th December 2015 at 170 Queens Gate, South Kensington Campus, Imperial College London.

To view the event brochure please click the image below.

Brochure

 

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RIVER trial – Research In Viral Eradication of HIV Reservoirs

RIVER Trial

Targeting the HIV ‘reservoir’ could be the first step to understanding how to cure the infection

The RIVER trial is now open for recruitment in the UK. It is one of the first clinical trials to test a new idea of how to cure HIV, through waking a ‘reservoir’ of cells infected with sleeping virus and killing them using the immune system. This idea has been called ‘Kick and Kill’ and this study will investigate if it might work.

The RIVER study is being conducted by the CHERUB collaboration, an alliance of HIV researchers at Oxford University, Imperial College London, the University of Cambridge, UCL, and King’s College London. The study is funded by the Medical Research Council with support from industry partners MSD and GSK.

There are 6 centres participating in RIVER: Royal Free Hospital, St Mary’s Hospital, Mortimer Market Centre, Royal Sussex County Hospital Brighton, Chelsea and Westminster Hospital and St Thomas’s Hospital.

The results of the RIVER study are expected in 2018.

Full article

If you would like to take part in the RIVER trial please see the MRC CTU at UCL website for more information.

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