HIV can evade treatment by hiding out within a patients’ own cells. Because they don’t always express tell-tale viral genes, the antiviral drugs cannot find and destroy them. But new research, published yesterday (July 25) in Nature, suggests that a cancer drug, known as vorinostat, may be the answer. After a single dose of vorinostat, which is used to treat certain types of lymphoma, patients experienced an almost 5-fold increase in HIV RNA expression
“HIV therapeutics is about to enter a new phase,” Steven Deeks of the University of California, San Francisco, wrote in an accompanying Nature commentary. “Over the past 25 years, the focus has been almost entirely on developing and optimizing drugs aimed at inhibiting active HIV replication.” This has led to numerous antiretroviral therapies that turned HIV from a death sentence into a largely manageable disease. “But [these therapies] do not eliminate inactive viruses within cells,” Deeks wrote. “[The new] clinical trial shows that a drug can revive HIV in patients as a potential first step towards a cure.”
In the study, David Margolis of the University of North Carolina at Chapel Hill and colleagues gave vorinostat to eight HIV-infected men. The patients’ disease was under control with antiretroviral therapy, but as is often the case, they harboured a latent infection of dormant viruses in their cells. Measuring the levels of active HIV before and after vorinostat administration, the researchers found, on average, a 4.5-fold increase in the levels of HIV RNA in CD4+ T cells, suggesting the latent viruses were becoming active once again.
“This work provides compelling evidence for a new strategy to directly attack and eradicate latent HIV infection," Margolis said in a press release. “Long-term, widespread use of antiretrovirals has personal and public health consequences, including side effects, financial costs, and community resistance. We must seek other ways to end the epidemic, and this research provides new hope for a strategy to eradicate HIV completely from the body.”