Packaging Nature in Just the Right Way To Kill HIV Dead

The development of highly active anti-retroviral treatment (HAART) for HIV in the '90s is widely credited with turning a certain and excruciating doom into a chronic illness. Nowadays, instead of futilely fighting off opportunistic infections as a...

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Oct 24 2012, 8:18pm

The development of highly active anti-retroviral treatment (HAART) for HIV in the ‘90s is widely credited with turning a certain and excruciating doom into a chronic illness. Nowadays, instead of futilely fighting off opportunistic infections as a patient’s immune system nosedives, said patient takes a daily cocktail of medications. However, said cocktail can cost nearly $20,000 a year (which should go down when generics hit the market soon) and involves the possibility of about every side effect you can think of, from vomiting to mood disorders to loss of body fat. Maybe you’ve seen ads around for prescription drugs to alleviate the effects of HIV prescription drugs. As far as treatments go, it’s hardly perfect, and, what’s more, if a patient stops taking it every day, their viral load will quickly go through the roof and they’re very soon back in the doom zone.

Cures and vaccines might get all the hype, but finding better treatments/therapies is crucial. One potential treatment that was thought to be a non-starter is using antibodies, proteins your immune system uses to tag foreign bodies—like viruses—for attack. The problem with antibodies is that HIV is almost supernaturally good at mutating. And once the virus changes into something else, the antibodies your body produced to attack it become worthless. But they might be the key to a whole new generation of treatments, if those antibodies can be harnessed in the right way. These are treatments that very notably wouldn’t have nearly the same side effect potential as HAART, because they’re created by the body.

A post at Science explains:

The most powerful antibodies against HIV are isolated from untreated people who have failed to control their HIV infection for many years. These so-called broadly neutralizing antibodies (bNAbs) do little to help the people who produce them, but their existence indicates that mutations have created an increasingly diverse population of the virus, which in turn has pushed the immune system to evolve a response that is both more potent and works against more variants. Unfortunately, the virus readily mutates around each individual’s bNAbs, too. But a team led by immunologist Michel Nussenzweig of the Rockefeller University in New York City has shown that it may be possible to outwit the virus by combining several bNAbs that target different parts of it.

As described in a paper out today online in Nature, the Rockefeller team has only made this work in lab mice. The paper’s abstract reads: “Although HIV-1 can escape from antibody monotherapy, combinations of broadly neutralizing antibodies can effectively control HIV-1 infection and suppress viral load to levels below detection. Moreover, in contrast to antiretroviral therapy10, 11, 12, the longer half-life of antibodies led to control of viraemia for an average of 60 days after cessation of therapy.” That 60 days is potentially huge.

Likely problems include the costs in creating antibody cocktails (not at all cheap), and also that mice typically don’t have HIV infections nearly as well-developed as they are in humans. So: the next step is to test it in actual humans. It’s not a potential cure, but a side effect-free treatment that you only have to take every two weeks or every month is the next best thing.

Reach this writer at michaelb@motherboard.tv.