developing longer-acting options<\/a>, including weekly and monthly pills, and shots that could be given just once a year.<\/p>\nBut scientists still aspire to develop \u201cfunctional cures\u201d that would effectively control H.I.V. over a lifetime, even if they do not eliminate it.<\/p>\n
\u201cPeople are really working hard on trying to cure it, and we\u2019re making progress,\u201d said James Riley, an immunologist at the University of Pennsylvania who is also modifying immune cells to control H.I.V.<\/p>\n
Since the 1990s, many scientists have tried to modify immune cells called T cells to attack H.I.V., but those efforts were mostly unsuccessful. Some research teams lost interest after the arrival of powerful antiretroviral drugs soon after.<\/p>\n
Cancer researchers soldiered on and succeeded in using the approach against blood cancers like leukemia.<\/p>\n
\u201cCancer will always probably be the pioneer in this stuff, because of the incredible unmet medical need,\u201d Dr. Riley said. <\/p>\n
In the new study, scientists at Caring Cross, a nonprofit focused on developing affordable immunotherapies, engineered immune cells from each study participant to carry two molecules on the cell surface. Both molecules bind to H.I.V. and kill infected cells, but one also prevents the immune cells from becoming infected.<\/p>\n
\u201cIt\u2019s this dual nature of targeting \u2014 killing and protecting \u2014 that we think is the missing piece in terms of how this therapy works,\u201d said Boro Dropuli\u0107, the executive director of Caring Cross, who developed the method.<\/p>\n
The researchers extracted immune cells from each participant, modified the cells, then injected them back in. The participants stopped taking antiretroviral drugs the day of the infusion. <\/p>\n
If a person does not take antiretroviral drugs, their H.I.V. levels typically soar within two weeks. But one person in the trial partially suppressed the virus for 12 weeks before rebounding. Two others were still in remission, 92 and 48 weeks after their infusion. <\/p>\n
All three had begun receiving antiretroviral therapy within months of being infected. Three others who had lived with H.I.V. for longer before they were treated did not respond and needed to resume antiretroviral therapy. (A seventh participant showed signs of control seven weeks after infusion.)<\/p>\n
Those details may be important. Those who were treated early in infection may have less H.I.V. sequestered in their body. Their immune system may also be less ravaged by the virus, and therefore more likely to rally when infused with the modified cells.<\/p>\n
\u201cThree out of three people with early disease doing some degree of control, to me, is the most provocative finding here,\u201d Dr. Deeks said.<\/p>\n
The two people with long-term response did show some blips of viral replication that quickly died down. That is to be expected as H.I.V. emerges from its reservoirs and is quashed by the immune cells.<\/p>\n
Still, the results were exciting, several experts said.<\/p>\n
The numbers in the study are very small but \u201cthese n-of-ones are so powerful because they encourage further research,\u201d said Dr. Mike McCune, the head of a division at the Gates Foundation that supports innovation in H.I.V.<\/p>\n
\u201cFor us, what\u2019s important is to make sure that we can go from an n-of-one to an n-of-a-million or more,\u201d he said. \u201cAnd the only way to do that is to engage companies that know how to make products.\u201d<\/p>\n
The foundation has not invested in work that involves removing immune cells and reinfusing them back into the individual. That approach is too invasive and expensive to reach the millions who will need it, Dr. McCune said. But it is actively pursuing scalable options.<\/p>\n
Cancer researchers are already showing success altering the immune cells while they are still in the body, which should eventually be cheaper by orders of magnitude.<\/p>\n
The direct injections could be produced \u201cfor less than $10,000 and then be off-the-shelf, meaning you can have them ready when a patient or person living with H.I.V. comes in,\u201d Dr. Kiem said.<\/p>\n
Other groups are working on broadly neutralizing antibodies, rare molecules that can disable a wide range of H.I.V. versions by targeting parts of the virus that do not mutate.<\/p>\n
\u201cIf we can combine these two approaches, that really may be synergistic and provide a pathway to deliver something close to a functional cure long term,\u201d Dr. Riley said.<\/p>\n
Anticipating long-term needs, Caring Cross is working with organizations in Brazil, India and elsewhere to manufacture the products for cancer at much lower costs. The team is also refining the tools and approach for H.I.V. and plans to begin a bigger study later this year.<\/p>\n
\u201cThis is a first-in-human approach,\u201d Dr. Deeks said. \u201cWe often come up with new theories as we do this, and that\u2019s what\u2019s happening as we speak.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"For about a decade, scientists have had remarkable success curing some blood cancers by modifying a patient\u2019s own…\n","protected":false},"author":2,"featured_media":637210,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[10308,687,275182,37018,97,5451,30319,4530,1728,5284,17345],"class_list":["post-637209","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health","tag-blood","tag-cancer","tag-caring-cross","tag-genetic-engineering","tag-health","tag-immune-system","tag-immunotherapy","tag-innovation","tag-research","tag-san-francisco","tag-university-of-california"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/637209","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/comments?post=637209"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/637209\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media\/637210"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media?parent=637209"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/categories?post=637209"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/tags?post=637209"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}