APLA Looks Toward a Cure in "HIV Matters" Town Hall Forum
On Nov. 14, the AIDS Project Los Angeles held its quarterly "HIV Matters" town hall forum in West Hollywood. The discussion for the event focused on HIV cure research, a promising field of medical study that has made significant advances since the disease first surfaced 31 years ago. The forum featured an interactive presentation from leading research experts from UCLA and City of Hope, who presented updates in HIV/AIDS treatment, care and biomedical prevention.
The guest speaker for the event, and possibly the lone symbolic figure leading this hope for a cure, was Timothy Ray Brown, a.k.a. "The Berlin patient." Brown is the only known person worldwide to have been effectively cured of HIV. Four years ago, Brown was given this title in an article published in the New England Journal of Medicine. Brown recently agreed to release his name and this past summer launched The Timothy Ray Foundation in a global effort to find a cure for HIV.
"I didn’t really believe I was cured of the disease until the journal published my case report," said Brown to the appreciative crowd. "When such a distinguished medical authority prints your name and says you’re really cured, (laughs) I guess it’s really true."
The focus of the forum was on gene therapy and stem cell research for the audience filled with mostly survivors of the disease, eager to hear the latest reports from the medical front. Brian Risley, manager and head of the treatment education program at APLA, led the discussion.
HIV cure research is still in its infancy, but as a direct result of the Brown case in 2009, it has showed the scientific community a proof of concept that a cure is possible. Brown had been living in Berlin, Germany, where he was diagnosed with not only HIV, but also leukemia. He was receiving treatments for both diseases, but the chemotherapy treatments made him ill.
The doctors place Brown in a temporary, medically-induced coma to allow his body to recover. As a test, the physicians also decided to transplant resistant blood stem cells that they hoped would cure Brown’s cancer, but they discovered that genetic mutations made the cells HIV-resistant. Doctors declared Brown "cured" soon after this blood stem cell transplant.
"In recent clinical trials, we’ve produced HIV-resistant T cells in patients who received a transplant with gene modified stem cells," said Dr. David DiGiusto, one of the keynote speakers for the event. "These new cells express small RNA molecules and interrupt the growth of the virus."
DiGiusto is the director of Cellular Medicine at City of Hope and is one of the leading faces in the development of potential gene therapy for HIV infection. Three years ago, City of Hope received nearly $34 million in stem cell research grants.
DiGiusto went on to describe how this type of gene therapy will use blood stem cells engineered to create new immune cells resistant to HIV infection. While the therapy is showing promising clinical results, DiGiusto also explained the cons of such stem cell treatments, such as finding a compatible donor candidate and of the high dose of the stem cells needed for the transplant, making the cost of the treatment too expensive for general use.
"Gene therapy focuses on blood cells to protect and to get rid of the infection," said Dr. Ron Mitsuyasu, the director of AIDS research at UCLA. "If we can replace the gene pool with good cells, you can live without having to take daily medications, but learning how to flush out the infected cells is still in the early stages at our clinic."
Mitsuyasu continued the conversation by explaining gene therapy involves inserting genes into a person’s cells with the aim of providing treatment for the HIV virus. A healthy and normal gene is inserted into a cell (or tissue) to replace a gene that is abnormal.
"It may not get rid of the HIV virus," Mitsuyasu continued, "but if we could reduce the number of infected cells, it’s a step forward in ending HIV infection and certain blood cancers."
The final speaker for the evening was Dr. Jerry Zack, the associate director of the UCLA AIDS Institute, who concluded the discussion with his studies for eradicating HIV: activating latent virus from viral reservoirs. A latent infection is a phase in a viruses’ life cycle in which after initial infection, virus production ceases.
"We’ve found that even after we’ve eliminated the body’s active HIV cells, a missed dose of drugs can allow the hibernating virus to emerge and ravage its host all over again," Zack explained.
Although antiretroviral therapy helps people infected with HIV to effectively control their virus levels, some of the virus remains hidden in cells and tissues where it’s not susceptible to these treatments. Last summer, the UCLA AIDS Institute was awarded a lucrative five-year grant from the National Institutes of Health to develop strategies to rid the body of HIV. Zack explained that the primary goal of his research team is to eradicate these remaining HIV reservoirs.
"The treatments we are currently testing at UCLA are also extremely expensive," Zack said. "Insurance companies are in discussion because you have to look at the long term investment. If a patient will no longer have to take daily medicines for HIV, then the high initial cost for the treatments may make sense."
Representatives from the UCLA AIDS Institute were on hand to answer questions and to signup interested audience members for several of their research programs: Biomedical Prevention, Vaccine Concept Development and HIV Therapeutics.
Upcoming events sponsored by APLA will be the local food drive initiative to honor "World Aids Day" on Saturday, Dec. 1. The countywide food drive is to secure donations of non-perishable food and personal hygiene items for persons living with HIV/AIDS. Donations collected at the food drive will help supplement the food provided to the clients who visit the food pantries every week. More information, a list of items and drop off places may be found at www.apla.org/fooddrive.