Following the news of a UK patient (The London Patient) who has been in remission with undetectable levels of HIV viral load for 18 months, becoming the second patient who has experienced disease free remission from HIV,
Patrick Aiyes, MEng, Immunology Analyst at GlobalData, a leading data and analytics company comments:
“The London Patient, similar to the Berlin patient, was also suffering from advanced Hodgkin’s lymphoma and doctors were using a stem cell transplant from an HIV-resistant donor aiming to treat the cancer and not the HIV. The treatment used is not appropriate in other HIV patients, due to the adverse events from chemotherapy used to treat the lymphoma. As a result, a cure for the entire HIV-positive population is still miles away despite this exciting development.
“Results from the REDUC trial, an open Phase I/IIa study to evaluate the efficacy and safety of using Bionor’s Vacc-4x and Celgene’s romidepsin on the HIV reservoir in virologically suppressed adults, displayed that although total HIV DNA levels declined during treatment, the decrease in HIV DNA from baseline after eight weeks was not statistically significant compared with the placebo group.
“This was the first trial that studied the workability of the ‘kick and kill’ approach, but it demonstrated that more R&D is required to achieve a sizeable effect that would actually benefit HIV patients. However, it is also important to note that the primary endpoint is not an established endpoint for cure, as there is not enough clarity on how to measure the HIV reservoir accurately.
“However, there are more early-stage approaches, such as ‘Sangamo Therapeutics’, which has a Phase II gene therapy treatment that can alter the immune system of patients. Sanofi is also developing a tri-specific broadly neutralizing antibodies that will have a diverse range of coverage of more than 200 HIV strains. With promising early-stage strategies being developed, there is still a chance the virus can be stopped.
“However, the real challenge that lays ahead will be developing a strategy that can be scaled for the millions who suffer from the disease; this alone will take a number of years.”