Medications for the treatment of various conditions have been examined as a potential HIV cure. Back in 2017, researchers experimented with a cancer medicine. JQ1, a potent chemotherapeutic drug, revealed its ability to reactivate the latent HIV, allowing for its eradication.
New clinical experiments with another cancer medication suggest it could also be used to kill the “silent” HIV cells – a problem that traditional therapeutic approaches haven’t been capable of tackling up till now.
Hunting the Silent Killer
Venetoclax, a blood cancer medication, has been examined for its ability to target the latent HIV infection.
Walter and Eliza Hall Institute of Medical Research (WEHI) and Doherty Institute for Infection and Immunity researchers worked together on a clinical trial meant to assess venetoclax’s ability to reactivate the latent human immunodeficiency virus.
The medication established itself as an effective option for attacking dormant HIV cells and delaying viral rebound by as much as two weeks. The term viral rebound refers to having detectable HIV levels in the blood after a period of complete viral suppression.
Venetoclax was capable of delaying rebound even in individuals who weren’t on antiretroviral therapy (ART) at the time they were given the cancer medication.
The Limitations of Current HIV Treatments
Antiretroviral medications are very effective for the management of HIV. In fact, people who are meticulous with their ART can achieve undetectable viral load and maintain it in the longer run.
Unfortunately, ART has its limitations – issues that keep the medications from eradicating the virus altogether.
HIV is very sneaky and it has the ability to remain latent for prolonged periods of time. The virus can “hide” from the immune system in various ways. ART cannot target HIV that isn’t active. Thus, even if a person achieves undetectable status, the HIV infection will come back in the event of therapy being discontinued.
The study quoted above is the first one that examines the effectiveness of venetoclax for the targeting of dormant HIV.
The best thing that researchers established is that venetoclax can be used alongside other medications, allowing for the creation of a comprehensive therapeutic approach. It’s long been established that developing a single medication for the treatment of HIV may be impossible. Using different classes of drugs that produce specific effects is a much better way to deal with a virus capable of mutating and exploiting immune system vulnerabilities.
More Work to Be Done
In the first clinical trial of this kind, venetoclax proved capable of destroying infected CD4 cells that carry the human immunodeficiency virus DNA.
The effect was selective, meaning only infected cells were targeted.
In the end of 2023, a Phase I/IIb clinical trial will start in Denmark to better understand how the cancer drug can be used to treat and cure HIV. Depending on the results, the trial could be extended to Australia in 2024.
Apart from testing effectiveness, the trial will also be carried out to determine whether the venetoclax HIV treatment is safe and well tolerated by patients. Participants in the experiment will be HIV-positive individuals who are already on antiretroviral therapy.
Challenges HIV Puts on the Table
As already mentioned, killing off active HIV isn’t enough to eliminate the infection altogether.
When it enters the body, HIV can create reservoirs of latent viral DNA. These can be reactivated weeks, even months after the original infection occurs. Infected cells that have latent DNA cannot be targeted by antiretroviral drugs. This is why HIV-positive individuals need to be on treatment for life.
In other words, ART is simply used to kill the active HIV. Therapeutic approaches involving medications like venetoclax use the “shock and kill” method to produce better results.
Through the use of such drugs, researchers can activate viral transcription, protein expression and virion production using a latency reversing agent (in this instance, the agent is the blood cancer medicine). The approach is known as shock and kill because it activates hidden HIV in order to eradicate such particles.
Until present, activation of latent HIV was mainly possible in vivo without significant clearance of the reactivated cells. Antibodies, T-cell vaccines and various classes of immunotherapy drugs have been used for the purpose.
Experimentation with different kinds of latency reversing agents is the key to making shock and kill a viable therapeutic approach to be incorporated as a part of ART. And while several medications show promise, there’s still a long road to travel before the new endeavours are deemed successful.
HIV Management Saves Lives
While we are waiting for the development of the most effective HIV cure, it’s important to highlight the fact that the condition is manageable.
The first step towards HIV management is learning your status. Singapore offers reliable, confidential and quick HIV testing options. Licensed facilities like Shim Clinics have a full range of prevention and treatment services that employ the newest and most effective therapeutic approaches.
Visit us during working hours every day of the week or contact Shim Clinic now to have your most pressing questions about HIV answered.