Miracle Cancer involving therapy engineering of the patient’s own immune cells is being retargeted for HIV, and early results from two people show its promise for long-term viral control.
As part of a clinical trial, scientists took people’s own immune cells and reprogrammed them in the lab to recognize and attack HIV in the body. After a single infusion of the modified cells, two people with HIV now have undetectable levels of the virus—one for nearly two years and the other for nearly a year. Both have been able to completely stop taking HIV drugs.
The two men are part of a small study to test the safety and feasibility of the treatment. The preliminary results were announced last week at the annual meeting of the American Society for Gene and Cell Therapy in Boston.
“These are early days. If we can provide proof of concept that this approach is safe and effective, then there are many ways it can be improved, to make it more affordable and scalable,” says Steven Deeks, professor of medicine and HIV expert at the University of California, San Francisco, who led the trial.
The technique, known as CAR-T cell therapy, has been used in tens of thousands of patients and difficult-to-treat cancers. Half a dozen or more drugs have been approved that are based on that technique. The treatment basically increases a person’s immunity to directly attack and eliminate cancer cells. Recently, it has also been successfully used to treat severe autoimmune diseases.
“This is very exciting,” says Andrea Gramatica, vice president of research at affAR, the Foundation for AIDS Research, who was not involved in the trial. “The reason this study is so important and so important is because it gives the HIV field real, clinical evidence that teaching the immune system to control the virus without antiretroviral therapy is achievable.”
Scientists have been searching for a cure for HIV since the virus was first identified in the early 1980s. Antiretroviral therapy stops the progression of AIDS by suppressing the virus to undetectable levels, but people must take drugs for the rest of their lives. It has transformed HIV into a chronic condition that allows people to have an almost normal life expectancy. However, not everyone with HIV knows their status, and in some rural and low-income areas of the world, these drugs are still not widely available or affordable.
So far, they are under several documented cases of sustained remission from HIV—known as an “active cure” because the virus is still in the body but has been suppressed to levels undetectable by the immune system and HIV drugs are no longer needed.
Each of the men developed cancer and underwent a stem cell transplant as part of their treatment. In all but one of those casesdoctors used stem cells from donors with a rare genetic mutation called CCR5 that normally prevents HIV from entering and infecting healthy cells. Timothy Ray Brown, known as the “Berlin patient,” was the first known person to be cured of HIV this way in 2008.
Examples of sustained remission “have taught us that the immune system can, under the right conditions, eliminate HIV,” says Boro Dropulić, executive director of the Maryland-based nonprofit Caring Cross, which developed CAR-T therapy for HIV.
But stem cell transplants are not dangerous, he says. They are serious procedures that carry significant risks such as graft-versus-host disease, when the transplanted cells recognize the recipient’s cells as foreign and attack them.
“What we’re trying to do is create those results on purpose without needing cancer, without needing special donors,” Dropulić says. His organization is working to make advanced treatments like CAR-T more accessible and affordable.
