Best thing since HARRT

[sam66]

       
        It's been about 13 Years since advent of HARRT.
        I only had to deal with this for two years, (two years since I found out I was positive )
        My utmost respect to those of you who been fighting it for a long time.
       

        My question is which one of the breakthroughs do you think shows best promise for a new kind
        of treatment.

        My favourites are :  The Berlin Patient ( the only time HIV has been stopped ) without further
                                 treatment , ok it's a bit risky, treatment might kill you.

                                 Vacc-4x ,   latest results been a bit disappointing, but a new approach by
                                  Bionor Immuno .

                                 Gene therapy, again lot of promise

                      And  :   Shock and kill , (latent reservoirs )
                http://www.aidsmap.com/en/news/1C0072A7-115D-496D-89DB-8F25B8C5051B.asp           
                               
             I'd be interested to know which line of research you think has a chance of making it to the end
             
             OK we are down to one pill a day + whatever pills to treat side effects
             It's been 13 years, we got to be due for a new kind of treatment

[John2038]

                                 Vacc-4x ,   latest results been a bit disappointing, but a new approach by
                                  Bionor Immuno .

The results are still encouraging IMHO, and I will wait to see the contribution of the C5 (to reduce inflammation) before concluding about the Vacc-4x. At least, it is able to increase the CD4 count and have already allows people to stay HAART free for a median time period of 31 months.

In more, Vacc-4x + HAART can maybe drastically reduce the probability to develop AIDS: more study are needs again to conclude. We will now before 4 years.

Gene therapy looks definitely promising for me, as many others on-going approach already mentionned in this forum.

[sensual1973]

i only see new meds for the next 10 years atleast (my opinion).gene therapy is interesting though but still very very early.

[John2038]

Therapeutic vaccines and Immune-Based therapies are becoming more and more popular, and it's a very good things, compared to a meds only pathway.

Some renewed scientists see the cure (could it be functional) to be discovered in the next 5 years while some others believe only in the functional cure (HIV will never be eradicated but its impact) in a distant horizon.

Things would have come much faster if there was a much better coordination between all theses researches made.

At least today, we knows that the berliner patient is still HIV free and this is just a fabulous news.
In 1989 already, Dr. John Rossi have treat 41 year old patient with AIDS and lymphoma.
The patient underwent radiation and drug therapy in removing his bone marrow and receiving new cells from a donor. Whether the donor had the CCR-5 Delta-32 gene mutation or not is not known, but when the patient died of his cancer at age 47 autopsy tests from eight organs and the tumor revealed no HIV.

So maybe today already, cell transplantation can cure HIV .

Surprinsingly, to few researches are on-going to try to achieve the same results without having to go through a chemio.
But my feeling is that this is the most interesting and promising research we could never do.

Finally, I guess that anything that may become available before we succeed finding a cure will just allows us to continue live better, safer and longer, as many studies have already demonstrated.

The lifts this year of the stem cells ban by Obama is another reason to hopes we will knows the cure.
Being able to access it is another question. But at least, the day the cure will be find, we will be able to put billions in making it available to everybody.

[Assurbanipal]

I think it is genetic based therapies -- probably with a large dose of IT added in. 

Yesterday I heard an ad on the radio for cancer treatment that is targeted to the specific genetic makeup of the individual cancer -- 5 years ago that was science fiction!

[tommy246]

My money is on the stem cell to come good eventually not just with hiv but many other infections, i also believe we will have better options than haart within the next 5 years along the lines of   some sort of toxic free injection once or twice a year.

[sam66]

Things would have come much faster if there was a much better coordination between all theses researches made.

        Agree John, some times it seems like there is not much collaboration between researchers, I hope I'm wrong.

My money is on the stem cell to come good eventually not just with hiv but many other infections,

         
          I   think so  Tommy , I found this article on the success of stem cell treatment.

      A man partially blinded in an attack on Tyneside has praised scientists who restored his vision using    stem cells.

Russell Turnbull, 38, lost the sight in one eye in 1994 when he was squirted with ammonia after intervening in an argument on a bus in Newcastle.

He was left with Limbal Stem Cell Deficiency (LSCD), a painful condition which requires constant treatment.

He said the Newcastle University team which developed the treatment had "transformed his life".

The method involves taking a small amount of stem cells from a patient's good eye, cultivating them in a laboratory, and implanting them into the damaged cornea.

      http://news.bbc.co.uk/1/hi/england/tyne/8425978.stm

[TheRoof]

My money is on the stem cell to come good eventually not just with hiv but many other infections, i also believe we will have better options than haart within the next 5 years along the lines of   some sort of toxic free injection once or twice a year.

If they developed a type of injection that you would need to take two times a year. I would be content with that for sure.

But nothing in this world is free. That stuff will probably cost a pretty penny to inject. Especially if you're from the States IMO.

[hotpuppy]

Here are my thoughts:

- Next most promising therapy:
   HAART to undetectable for 6 months followed by "maintenance" therapy with something like a entry inhibitor for R5 tropic infections.  This would essentially be one pill like Selzentry (mariviroc) or Vicriviroc.

- Genetics:
   HELL NO.  Looks good in print but we just don't understand enough to be playing with genetics.  It will be decades before we see cost-effective genetic therapy and the consequences for mistakes are dire.

 - Latent Reservoirs:
   I'm not optimistic.  What I understand is that your immune "memory" is from the "sleeping" immune cells that harbor HIV.  So eliminating them would wipe out your immune system in all likelihood.


I think we are far more likely to fine tune the chronic stage that we seemed to have reached.  In the process I think we will see new drugs come to market that are better optimized with fewer side affects and lower cost profiles.

The nasty reality is that not enough effort is on prevention right now and we are continuing to see infections.  I was involved with a HIV Prevention group a couple of years ago and they couldn't get any HIV Neg people to participate unless they worked for a ASO.  Pretty sad.

[burr0108]

Quick Reply to hotpuppy:

I agree fully with you on the next promising therapy being some sort of once every six month dosage.  The only reason we have to take pills daily now is that the half lives of these meds are relatively short.  However, if we could have drugs with longer half lives (yet not toxic) we may only need to take drugs once a week or once every two weeks.

However,  I need to disagree with your opposition to gene therapy.  If we could generate t-cells without CCR5 receptors (or another essential receptor), that would be a great way to keep those T-cells healthy in the presence of HIV.  This is exactly what they did with the Berlin patient.  Right now, we don't have the technology to make this affordable and safe for all.  However, there is great promise here, especially for those with low CD4 counts.

I am also bit more optimistic about attacking latent cells.  Valproic acid (an antiseizure drug) has been tested many times for the ability to activate latent cell, but without a great deal of success. Right now, though, clinical studies are being done on the premise that Raltegravir (an integrase inhibitor) is able to attack those latent reserves.  For example see the following:

http://ClinicalTrials.gov/show/NCT00863668?order=39

It is an interesting time in HIV research and we just need to keep following the news and trends.  Things WILL be very different in 5-10 years.