DESIGNING CLINICAL TRIALS IN HIV CURE RESEARCH
Now that several potential ways have been defined to eventually reach an HIV functional
cure, clinicians have to design the first clinical trials able to test these hypotheses, with a
balance between audacity and safety.
Toulon, France, January 02, 2012 -- Despite more than 15 years of successes with antiretroviral
therapy (ART), HIV remains present in hiding places called the HIV reservoirs”, which are
basically cells where the virus is inactively integrated into host chromosomes.
This explain why each time ART is stopped, the infection starts again, impairing more the immune
Furthermore, long-term ART goes with problems of compliance, toxicity, resistance, cost and
access, making life-long ART for the 34 million infected patients currently on earth an illusion.
It is therefore mandatory to investigate new ways of treating HIV to get some drug-free time. This,
also called “functional HIV cure” is a situation where HIV could remain non-replicative for months
without continuing ART.
At the last “International Workshop on HIV Persistence, Reservoirs and Eradication Strategies”
held in December 2011, the 215 participating scientists have defined 3 new directions to be
evaluated for a functional HIV cure:
- Purging the HIV reservoir by drugs like HDAC inhibitors, Interleukin-15, Bryostatin;
- Interfering with negative immune regulatory pathways by anti-PD1 antibodies;
- Making cells resistant to HIV by gene therapy.
However, all these strategies have potential risks and there might be no benefit from them for the
very first patients to be included in the first trials.
How can these risks be evaluated and what risk level can be accepted? These ethical issues are
part of the debate that keeps going after the workshop, during small meetings or via professional
With the next “International Workshop on HIV Persistence, Reservoirs and Eradication Strategies”
scheduled in Miami, Florida, 3-6 December 2013, scientists know that they have a very short
window of opportunity to be able to come with fresh data in 2 years. It absolutely needs the design
and launching of the new HIV cure clinical trials in the forthcoming months.
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