Towards an HIV Cure XIX International AIDS Conference

Media Coverage Towards an HIV Cure XIX International AIDS Conference

27 July 2012 CONTENTS

Wire ...... 4 Agence France-Presse...... 4 Agence France-Presse...... 5 Agence France-Presse...... 7 Agence France-Presse (English) ...... 9 Agence France-Presse (English) ...... 11 Agence France-Presse (English) ...... 12 Agence France-Presse (German) ...... 16 Agence France-Presse (Spanish) ...... 18 Agence France-Presse (Chinese) ...... 22 Agencia EFE (Spain) ...... 23 Asian News Service ...... 25 Associated Press ...... 27 Associated Press ...... 28 Australia Associated Press ...... 30 Bloomberg (USA) ...... 33 Reuters ...... 37 SIPA Press (France) ...... 39

Broadcast ...... 42 CNN (USA) ...... 42 Australian Broadcasting Corporation’s PM ...... 48 Australian Broadcasting Corporation ...... 51 Australian Broadcasting Corporation ...... 53 NPR’s Talk of the Nation ...... 56 NPR’s “All Things Considered” & Shorts Blog ...... 61 France Info ...... 65

Print ...... 66 Washington Post (USA) ...... 68 Economist (UK) ...... 70 Independent (UK) ...... 74 Wall Street Journal ...... 78

Original Online ...... 79 ABC News “Medical Unit” ...... 79 Boston Globe (USA) ...... 81 Boston Globe’s “White Coat Notes” ...... 83 CBS News (USA) ...... 85 Daily Mail (UK) ...... 87 Daily Mail (UK) ...... 89 El País (Spain) ...... 91 El País (Spain) ...... 93 El País (Spain) ...... 95 Europe 1...... 97 Forbes ...... 98 Forbes ...... 100

2 Guardian’s “Sarah Boseley’s Global Health Blog” ...... 102 Guardian’s “Sarah Boseley’s Global Health Blog” ...... 104 Guardian (Nigeria) ...... 106 Health Day ...... 108 Huffington Post’s “Healthy Living” ...... 110 International Business Times ...... 112 Independent (UK) ...... 114 La Croix (France)...... 115 Le Monde (France) ...... 117 MedPage Today ...... 119 MedPage Today ...... 121 MSNBC ...... 123 Nature (UK) ...... 126 NPR’s Boston Affiliate WBUR ...... 129 NPR’s “All Things Considered” & Shorts Blog ...... 131 South African Broadcasting Corporation ...... 133 Wall Street Journal’s “Health Blog” ...... 134 WebMD ...... 136

3 WIRE

Agence France-Presse

Sida: des séropositifs résistent au virus sans suivre un long traitement

WASHINGTON - Des patients contaminés en France par le virus du sida (VIH) et mis rapidement sous antirétroviraux restaient des années plus tard à l'abri de la maladie, sans même poursuivre leur traitement, selon une étude dévoilée jeudi à Washington.

Après avoir pris des antirétroviraux dès le début de leur infection (8 à 10 semaines après) une quinzaine de patients dits du groupe de Visconti ont arrêté ce traitement après moins de trois ans.

Plusieurs années plus tard, leur charge virale restait indécelable et le niveau de leurs lymphocytes T4, cellules-clé du système immunitaire, se maintenait à des niveaux élevés.

Onze de ces patients ont montré des similarités avec les sujets qui résistent naturellement au VIH et ce contrairement à ce qui avait été observé initialement, ont indiqué les chercheurs dont l'analyse a été présentée à la XIXe conférence internationale sur le sida, qui réunit plus de 20.000 délégués de 190 pays cette semaine à Washington.

Le niveau de leur réservoir viral est particulièrement bas, très comparable au très petit nombre de personnes qui résistent naturellement au virus du sida. Ce groupe maintient durablement le VIH à des niveaux imperceptibles sans jamais prendre d'antirétroviraux.

Et comme ces résistants naturels au VIH, les onze patients du groupe de Visconti avaient un très faible niveau de virus à l'état latent dans leur cellules immunitaires.

Ces observations laissent penser que prendre des antirétroviraux très tôt après le début de l'infection limite l'étendue de la contamination dans l'organisme et empêche la formation d'un réservoir viral important, a expliqué devant la presse le Dr Azier Saez-Cirion, de l'Institut Pasteur, l'un des principaux auteurs de l'étude.

Ces patients de la cohorte de Visconti ont des caractéristiques immunologiques et une capacité de résistance au VIH exceptionnelles. Ils représentent un groupe très prometteur pour trouver le moyen de maîtriser l'infection chez des séropositifs traités pendant au moins 12 mois, a-t-il dit lors d'une conférence de presse.

Mais pour un autre groupe de patients séropositifs, la résistance à l'infection après arrêt des antirétroviraux n'a été constatée que chez 10% d'entre eux. De ce fait, cet effet ne peut pas être encore extrapolé à l'ensemble de la population séropositive, concluent les chercheurs.

(©AFP / 26 juillet 2012 23h43)

Agence France-Presse

Sida: lancement d'une nouvelle stratégie pour guérir l'infection

De Jean-Louis SANTINI (AFP) – Il y a 21 heures

WASHINGTON — La Société internationale sur le sida (SID), qui rassemble des chercheurs à la pointe du combat contre la pandémie, a dévoilé jeudi à Washington une nouvelle stratégie visant à guérir l'infection. Jusqu'à présent, les traitements antirétroviraux découverts dans les années 90 permettent de contrôler le virus du sida (VIH) et de préserver la santé des personnes contaminées, mais pas d'éradiquer le pathogène. Cette initiative, élaborée au cours des deux dernières années, a été présentée avant le début de la 19e Conférence internationale sur le sida devant se tenir du 22 au 27 juillet à Washington. Quelque 25.000 participants sont attendus à cette conférence organisée par la SID. Il s'agit de mobiliser le monde scientifique, les pouvoirs publics, le secteur privé et les donateurs dans le monde pour accélérer les efforts de recherche et aboutir plus vite à un moyen de guérir le sida, qui a fait 35 millions de morts depuis son émergence il y a 30 ans. "Cette stratégie résulte d'un effort de collaboration entre 34 chercheurs qui a débouché sur une feuille de route pour faire avancer la recherche vers une guérison de la contamination par le VIH", a déclaré devant la presse le Dr Françoise Barré-Sinoussi, prix Nobel de médecine pour la co- découverte du VIH à l'Institut Pasteur à Paris. "La science nous dit depuis un certain temps qu'il est désormais réaliste de pouvoir guérir l'infecton du VIH et que le moment est venu de saisir l'occasion d'essayer de mettre au point un moyen de parvenir à une guérison", a expliqué Mme Barré-Sinoussi, future présidente de la SID. "Nous pourrions regretter de n'avoir jamais essayé", a-t-elle ajouté. Elle a toutefois admis en réponse à une question ne pouvoir dire combien de temps il faudrait ni combien pourrait coûter ce nouvel effort de recherche. Ce nouvel optimisme s'appuie sur un certain nombre d'avancées scientifiques qui aident à mieux comprendre les raisons pour lesquelles le VIH persiste à l'état latent dans l'organisme des malades traités avec des antirétroviraux. Les scientifiques savent que les "réservoirs viraux" où se cache le virus constituent l'un des principaux obstacles à une guérison, a expliqué Steven Deeks, professeur de médecine à l'Université de Californie à San Francisco. C'est précisément la raison pour laquelle les thérapie antivirales ne parviennent pas à éradiquer le VIH. "Nous n'avions pas jusqu'à très récemment une compréhension claire des raisons pour lesquelles le VIH persiste durant un traitement antirétroviral" à des niveaux imperceptibles, a-t-il ajouté. "Notre

5 compréhension des mécanismes de persistance du VIH à l'état latent est nettement supérieure à ce qu'elle était il y a dix ans", a souligné le professeur Deeks. Selon lui, "nous parvenons à un stade de l'épidémie auquel nous pouvons commencer sérieusement à tester des traitements pour, soit empêcher cet état latent du VIH, soit le forcer à sortir de sa cache pour le détruire. Steven Deeks a aussi indiqué que la recherche se penchait sur le cas de l'Américain Timothy Brown, dit le "patient de Berlin", seul connu au monde à avoir guéri du sida à la suite d'une greffe de moëlle osseuse pour traiter une leucémie. Le donneur était une des rare personnes capables de contrôler naturellement le VIH. Les virologues étudient également le cas d'un groupe de malades français qui ont pu arrêter une thérapie antirétrovirale sans que le virus ne réapparaisse. Mark Harrington, militant anti-sida de l'ONG "Treatment Action Group", a déploré lors de cette conférence de presse "le manque de volonté politique" pour une mobilisation globale visant à guérir le sida. Par ailleurs, des experts américains, dans un article publié vendredi dans la revue médicale The Lancet, affirment que les stratégies de lutte contre le VIH chez les homosexuels sont à revoir alors que le sida est considéré comme "une épidémie réémergente" pour eux dans de nombreux pays. http://www.google.com/hostednews/afp/article/ALeqM5j5x3P7bUfH7TDKSrLrL6dbwLATQw?do cId=CNG.c1ba8da92126cab1a07bc6561ff4816a.311

Agence France-Presse

Le professeur Barré-Sinoussi voit un nouvel élan vers la guérison du sida

AFP | 20 juillet 2012 08h27

WASHINGTON - Le professeur Françoise Barré-Sinoussi, Nobel de médecine 2008 pour la co- découverte du virus du sida, estime que guérir l'infection est désormais possible et a annoncé jeudi à Washington une stratégie mondiale pour mobiliser les talents et efforts vers cet objectif.

Cette annonce a été faite avant la 19e conférence internationale sur le sida qui se tient dans la capitale américaine du 22 au 27 juillet et où 25.000 participants sont attendus.

Q: Pourquoi peut-on davantage espérer aujourd'hui parvenir à guérir le sida?

R: Tout d'abord en raison de l'accumulation de nos connaissances scientifiques avec le patient de Berlin, le seul au monde qui semble avoir été guéri après avoir subi une transplantation de moelle osseuse, ce qui nous donne la preuve qu'arriver à éliminer le virus du corps est quelque chose de réaliste. La deuxième raison c'est que l'on a une petite proportion de patients --moins de 0,3%-- qui contrôlent naturellement leur virus de façon permanente sans jamais avoir reçu le moindre traitement. Enfin, nous avons un groupe de patients en France qui ont reçu un traitement classique par des antirétroviraux, puis qui les ont arrêtés et qui vivent aujourd'hui sans traitement en contrôlant parfaitement leur infection. On a également beaucoup appris ces dernières années sur les mécanismes qui expliquent pourquoi le virus reste persistant dans le corps (des personnes sous antirétrovitaux, ndlr). Ces mécanismes nous ont permis de commencer à élaborer des stratégies thérapeutiques dont certaines ont déjà donné des résultats préliminaires qui encouragent à poursuivre ces recherches. Il y a donc de l'espoir... mais ne me demandez pas de date, car nous ne savons pas.

Q: Le thème principal de la conférence de Washington est la possibilité de mettre fin à la pandémie avec les traitements antirétroviraux existants: est-ce possible, quand et à quel prix?

R: Sur le principe, oui c'est possible. Avec les traitements actuels on sait très bien qu'en 2050, si on suit les modèles (informatiques), et si toute personne infectée peut avoir accès au traitement, on devrait être capable d'éliminer cette épidémie mondiale. Dans la réalité, il y a des obstacles financiers, d'organisation et d'accès aux personnes touchées par le VIH (virus de l'immunodéficience humaine, ndlr). Il faut aussi lutter contre la discrimination et la stigmatisation, qui sont le premier obstacle. Pour le dépistage, il faut revoir le système de santé dans les pays les plus pauvres pour que toutes les populations, où qu'elles se trouvent, y compris dans des zones très retirées, puissent avoir accès aux tests et aux traitements. Ce qui fait de cette approche, que nous

7 souhaitons bien entendu, une approche difficilement réalisable sur le long terme. D'où l'idée d'associer, pour aller vers un monde sans sida, les traitements actuels et d'y greffer les nouveaux traitements de demain, car c'est grâce à eux qu'on arrivera à cette génération sans sida. Et à la conférence de Washington on attend une mobilisation plus forte, en particulier des politiques, pour justement élargir cet accès aux traitements actuels et pour continuer la recherche sur le VIH.

Q: Où en sommes-nous dans la recherche d'un vaccin?

R: La recherche vaccinale avance aussi en parallèle. Bien sûr l'essai clinique réalisé en Thaïlande a été le premier pour lequel on a constaté une petite efficacité, très modeste. On a appris et on continue à apprendre de cet essai clinique mais il faut en refaire de nouveaux car tout n'est pas exploitable. Et la recherche vaccinale continue avec une approche qui me semble bien meilleure à présent, car elle permet de déterminer les mécanismes précis qu'il faut savoir induire par un vaccin pour obtenir une protection.

(Propos recueillis par Jean-Louis SANTINI)

(©AFP / 20 juillet 2012 08h27) http://www.romandie.com/news/n/_Le_professeur_Barre_Sinoussi_voit_un_nouvel_elan_vers_la_g uerison_du_sida62200720120829.asp

Agence France-Presse (English)

'Cure' Research Suggests New Paths To Hiv Control

(AFP) – 1 hour ago

WASHINGTON — Three studies presented Thursday at a major world conference on AIDS show new ways that scientists are striving toward a cure for the three-decade-old disease.

One study focused on a group of 12 patients in France who began treatment on antiretroviral drugs within 10 weeks of becoming infected with human immunodeficiency virus, but then stopped the therapy.

The HIV virus stayed away for a median of six years in the group, known as the Visconti Cohort, which stands for "Virological and Immunological Studies in CONtrollers after Treatment Interruption."

This unique group of people did not completely eliminate HIV, but continued to possess it at an extremely low level in their cells and did not become sick.

"These results suggest that the antiretroviral treatment should be started very early after infection," said Charline Bacchus, lead researcher of the study at France's national AIDS research agency ANRS.

"Six years after interruption of treatment, patients treated early on in the post-infection period present a perfect ability to control the HIV infection."

Scientists are continuing to study the immune characteristics of this group for clues as to why they do not need prolonged medication. For most HIV patients, antiretroviral drugs must be taken for life.

There are currently 34 million people living with HIV worldwide. In the needy nations, the most affected by the pandemic, about eight million people are now taking antiretrovirals for treatment, about half those in need.

The second study involved two HIV-positive men whose DNA showed no trace of the virus eight and 17 months respectively after receiving stem cell transplants from an outside donor as treatment for blood cancer.

Their cases are unlike the well-known "Berlin patient," an American man who is considered cured of HIV and leukemia after receiving similar bone marrow transplants from a rare donor who was naturally resistant to HIV, or who lacked a CCR5 receptor.

These two men received transplants from donors with the CCR5 receptor, which acts as a gateway allowing HIV to penetrate the cells, so they were not afforded natural protection against the virus.

9 Researchers believe that by continuing to treat the men with antiretroviral drugs during the process, the medicine prevented the donor cells from becoming infected until they were able to provide the men with new immune defenses. The study was presented at the 19th International AIDS Conference by Daniel Kuritzkes, professor of medicine at Brigham and Women's Hospital in Massachusetts.

A third study on how a cancer drug helped purge HIV from the cells of patients was described by lead researcher David Margolis of the University of North Carolina.

Researchers used the chemotherapy drug vorinostat to revive and so unmask latent HIV in the CD4+ T cells of eight trial patients who were also taking antiretroviral drugs to stop the virus from multiplying.

Margolis, whose study was published Wednesday in the British journal Nature, told reporters that researchers are energized toward the goal of finding a cure for HIV, even if it remains many years away.

"You cannot argue with the value of the goal and we cannot get there without working on it and I cannot say how long it will take," he said.

"But I think there is a clear path and we can make progress." http://www.google.com/hostednews/afp/article/ALeqM5jmI8ryCuRlG6XmqzXBov5Z- sdGrw?docId=CNG.f14afb390e7dda24acd026cad5111c4b.ee1

Agence France-Presse (English)

Nobel laureate, discoverer of HIV, says cure in sight

(AFP) – 8 hours ago

WASHINGTON — The Nobel laureate who helped to discover HIV says a cure for AIDS is in sight following recent discoveries, in an interview with AFP ahead of a global conference on the disease. Francoise Barre-Sinoussi, who won the Nobel Prize in Medicine in 2008 as part of a team that discovered the human immunodeficiency virus (HIV), which causes AIDS, said scientific research was zeroing in on a cure for the illness.

She cited a patient in Berlin who appears to have been cured through a bone marrow transplant, "which proves that finding a way of eliminating the virus from the body is something that is realistic."

Other sources of optimism are the small minority of patients -- less than 0.3 percent -- who exhibit no symptoms of the virus without ever receiving treatment; and a small group in France who received antiretroviral drugs and now live without treatment or symptoms, Barre-Sinoussi said. "There is hope... but don't ask me for a date because we do not know."

She also said that it would be possible "in principle" to eliminate the AIDS pandemic by 2050, if barriers to drug access could be eliminated.

The main barriers there were not scientific but political, economic and social, she said: the problem was lack of access to testing and drugs in poor and rural areas, as well as the stigma around the virus, which undermines early detection and treatment.

Some 25,000 people -- including celebrities, scientists and HIV sufferers -- are expected in the US capital on Sunday to call for more strident global action to address the three-decade AIDS epidemic. Deaths and infections are down in the parts of the world most ravaged by the disease, while the number of people on treatment has risen 20 percent from 2010 to 2011, reaching eight million people in needy countries.

However this is only about half the people who should be on treatment worldwide, suggesting much more remains to be done.

More than 34 million people worldwide are living with HIV, a higher number than ever before, and around 30 million have died from AIDS-related causes since the disease first emerged in the 1980s, according to UNAIDS. http://www.google.com/hostednews/afp/article/ALeqM5h0WPLctMNQO7- idnsr0ARa_QejFA?docId=CNG.7e149505c0a1123c3b32ade2b8af1356.8f1

Agence France-Presse (English)

Scientists urge fresh push for AIDS cure

By Kerry Sheridan (AFP) | 22 hours ago

WASHINGTON — International scientists on Thursday urged a new push for a cure to AIDS, saying the three-decade epidemic is outpacing medications to curb it.

The seven-step scientific strategy focuses efforts on key areas such as the reservoirs where human immunodeficiency virus (HIV) holes up in the body, and the small number of people worldwide who seem to have some natural resistance.

The plan was published in the British journal Nature and discussed at a press conference in Washington, which is hosting the International AIDS Conference on July 22-27, expected to draw 25,000 experts and advocates.

"Finding a cure for AIDS is a critical innovation gap," said Michel Sidibe, executive director of UNAIDS.

Leading experts have touted progress in the fight against AIDS in recent days, with eight million people in needy nations now receiving antiretroviral treatment and a drop in the death toll from AIDS in much of the world.

But the cost of treating people with HIV, about 34 million people worldwide, "is overwhelming many organizations and public health systems," said the article by the International AIDS Society in Nature Reviews Immunology.

The United Nations has called for $22-24 billion per year to help curb the AIDS epidemic by 2015, and antiretroviral treatment accounts for up to 70 percent of those funds in the most afflicted areas, according to background information in the article.

"It is estimated that for every HIV-infected person who starts antiretroviral therapy, two individuals are newly infected with HIV; this is clearly unsustainable," it added.

Instead, cure researchers need more funds and a renewed focus on a roadmap to curing AIDS, according to Francoise Barre-Sinoussi, the co-discoverer of HIV, and director of the regulation of retroviral infections unit at the Institut Pasteur in Paris.

"The science has been telling us for some time now that achieving a cure of HIV infection could be a realistic possibility. The time is right to take the opportunity to try to develop an HIV cure," she said.

12 She said additional cure funding should not take away from current programs to treat and prevent the disease.

"However, it is imperative that donors, governments and the AIDS community make viable economic investment in HIV cure research, and right now," Barre-Sinoussi said.

The strategy was devised by the International AIDS Society, a team of more than 40 scientists active in HIV research.

Some promising findings are pushing the renewed effort toward a cure, including the well-known case of an American man, Timothy Brown, who was given a stem cell transplant for leukemia from an HIV resistant donor and still appears disease-free several years later.

The donor came from a very small group of northern Europeans who lack a protein on the surface of white blood cells known as CCR5, which serves as the gateway for HIV to enter the cells.

While the transplant was too risky to be considered an option for the general public, the operation provides what scientists call "proof of concept" that a functional cure can be achieved.

Another intriguing group of people in France, known as the Visconti cohort, became infected with HIV but began treatment early and were able to stop it without the infection returning. Their immune systems are being intensely studied.

The report said a number of strategies being probed -- from gene therapy to immune treatments and vaccines -- would likely be more efficient in combination with each other and with the use of antiretroviral therapy to ready patients' immune systems for a cure. http://www.google.com/hostednews/afp/article/ALeqM5grrmQ_Dwm_MMebCIxmF7k9JGT4aQ?d ocId=CNG.3323cc1e5d9410063f569c60a47dd4ac.1f1

Agence France-Presse (English)

Tentative Step Towards Aids 'Cure'

2012-07-25 22:48

Paris - Scientists in the United States said on Wednesday they had used a cancer drug to flush out the Aids virus lurking dormant in trial patients' white blood cells - a tentative step towards a cure.

The ability of the HIV genome, or reproductive code, to hide out in cells and be revived after decades poses a major obstacle in the quest for a cure.

Being able to expose the virus in its hiding place would allow scientists to target the host white blood cells in a killing blitz.

"It is the beginning of work toward a cure for Aids," David Margolis, co-author of the study published in the journal Nature, told AFP as the International Aids Conference was under way in Washington.

HIV is a retrovirus, inserting its DNA into the genome of host white blood cells, CD4+T cells in this case, and turning them into virus factories. Sometimes it goes into hiding in some cells even as others keep on producing.

About 34 million people around the world are living with HIV, which destroys the immune system and has caused about 30 million Aids-related deaths since the disease first emerged in the early 1980s.

In the latest study, researchers in the United States used the chemotherapy drug vorinostat to revive and so unmask latent HIV in the CD4+T cells of eight trial patients.

The patients were also on antiretroviral drugs, which stops HIV from multiplying but have to be taken for life because they do not kill the virus hidden away in reservoirs.

"After a single dose of the drug, at least for a moment in time, [vorinostat] is flushing the virus out of hiding," Margolis said of the trial results - the first drug ever shown to do so.

"This is proof of the concept, of the idea that the virus can be specifically targeted in a patient by a drug, and essentially opens up the way for this class of drugs to be studied for use in this way."

Enzyme The drug targets an enzyme that allows the virus to lie latent.

The researchers cautioned that vorinostat may have some toxic effects and stressed this was merely an early indication of feasibility that had to be explored further. Exactly what would happen after the virus was unveiled in reservoir cells was also not certain, said Margolis.

"We know that many cells that produce HIV die in the process. We know many cells that produce HIV can be identified and killed by the immune system.

As far as we can tell, all the viruses floating around while patients are taking therapy don't get into cells because they are blocked by the therapy," he said. Without a host cell, the virus would die within a few minutes.

"There is a possibility that this could work. But ... if it is only 99% true and one percent of the virus escapes, it won't succeed. That is why we have to be careful about our work and what we claim about it."

In a comment published with the study, HIV researcher Steven Deeks said the research provided "the first evidence that ... a cure might one day be feasible".

Ethical concerns But, as is common with early clinical trials, the study raised more questions than answers - including ethical concerns about giving potentially toxic drugs to HIV-infected people who are otherwise healthy, he said.

"These data from the lab of David Margolis are genuinely exciting for those exploring pathways to achieving a cure for Aids," Oxford University HIV researcher John Frater told AFP, calling for investment in further research.

HIV immunologist Quentin Sattentau called the findings promising, but said other types of reservoir cells, including in the brain, may not respond to this treatment. "Thus there is a long way to go before we will know if this can work to completely eradicate HIV from an infected person." - AFP http://www.news24.com/SouthAfrica/AidsFocus/Tentative-step-towards-Aids-cure-20120725

Agence France-Presse (German)

Vor Aids-Konferenz: Experten haben Hoffnung auf Heilung

(AFP) | Vor 5 Stunden

Washington — Aids-Experten halten eine Heilung der Immunschwächekrankheit für möglich. Dank neuer Therapien sei es "realistisch", das HI-Virus eines Tages vollständig aus dem Körper eines Infizierten entfernen zu können, sagte die renommierte Aids-Forscherin Françoise Barré-Sinoussi vor der internationalen Aids-Konferenz, die am Sonntag in Washington beginnt. Vor allem für Homosexuelle ist das Ansteckungsrisiko nach wie vor sehr hoch.

"Es gibt Hoffnung", sagte Barré-Sinoussi, die 2008 für die Entdeckung des HI-Virus mit dem Medizin-Nobelpreis ausgezeichnet wurde, der Nachrichtenagentur AFP. Als Beispiel nannte die Französin einen Berliner HIV-Patienten, der nach einer Knochenmarkstransplantation als geheilt gilt. Wann es ein Heilmittel gegen Aids gebe, könne sie aber nicht sagen, "denn das wissen wir nicht".

Der österreichische Mediziner Gottfried Hirnschall, der das Aids-Programm der Weltgesundheitsorganisation (WHO) leitet, rechnet zumindest mit einem Durchbruch bei den Neu- Infektionen. Die Aids-Forschung mache so große Fortschritte, dass die Medizin erstmals "in Betracht ziehen" könne, Ansteckungen vollständig zu verhindern, sagte er. Entscheidend im Kampf gegen Aids seien auch neue Medikamente, die besser wirken und weniger Nebenwirkungen haben. Auch nach drei Jahrzehnten Aids-Aufklärung ist das Risiko für homosexuelle Männer, an Aids zu erkranken, aber nach wie vor deutlich höher als bei Heterosexuellen. Das geht aus einer Studie hervor, die von der Fachzeitschrift "The Lancet" veröffentlicht wurde.

Der Studie zufolge sind in den USA, in Chile, Spanien, Thailand, Malaysia, Südafrika und einigen Ländern in der Karibik mindestens 15 Prozent der Homosexuellen mit dem HIV-Virus infiziert. Ein wesentlicher Faktor seien dabei häufig wechselnde Sexualpartner. Auch sei die Ansteckungsgefahr bei ungeschütztem Analsex 18 Mal höher als bei vaginalem Geschlechtsverkehr.

Werbekampagnen für die Verwendung von Kondomen sind nach Überzeugung der Forscher nicht ausreichend. Sie empfehlen Homosexuellen, vorbeugend antiretrovirale Arzneimittel zu nehmen - auch für noch nicht HIV-Infizierte.

Zu der Konferenz in Washington, die am Sonntag unter dem Motto "Das Blatt gemeinsam wenden" beginnt und bis zum 27. Juli dauert, werden rund 25.000 Teilnehmer aus über 190 Ländern erwartet. Darunter sind auch hochkarätige Gäste wie US-Außenministerin Hillary Clinton und ihr Mann, der frühere US-Präsident Bill Clinton, der Popstar Elton John und Microsoft-Gründer Bill Gates.

16 Das UN-Kinderhilfswerk UNICEF rief vor der Konferenz dazu auf, vor allem die Übertragung des HI- Virus von Müttern auf ihre Babys künftig zu verhindern. Noch immer würden täglich rund 1000 Kinder infiziert, weil es in den am meisten betroffenen Ländern an Behandlungsmöglichkeiten und Aufklärung fehle. Dabei könne eine solche Übertragung "auch in Entwicklungsländern zu 100 Prozent verhindert werden", erklärte der deutsche Geschäftsführer Christian Schneider. Um die Zahl der HIV-Infektionen bei Kindern zu senken, sind laut UNICEF vor allem schnelle und einfache Diagnosen nötig. Ein sogenannter Trockenbluttest mache einen Transport zu den oft weit entfernten Laboren überflüssig. Mit einem speziell entwickelten SMS-Programm könnten die Testergebnisse zudem deutlich schneller übermittelt werden, so dass auch die Behandlung früher beginnen könne. http://www.google.com/hostednews/afp/article/ALeqM5jjkYRP0768Zee1Z9xe4lKQXa5w8w?docI d=CNG.e33c8e069f062bccd6f59a28054f76e8.291

Agence France-Presse (Spanish)

Científicos internacionales lanzan estrategia global para curar el sida

Por Kerry Sheridan (AFP) – hace 20 horas

WASHINGTON — La Sociedad Internacional del Sida (AIS, por sus siglas en inglés), que reúne a los investigadores a la vanguardia de la lucha contra la pandemia en el mundo, anunció el jueves en Washington una nueva estrategia para curar la infección. Hasta ahora, el tratamiento antirretroviral descubierto en los años 1990 para controlar el virus de inmunodeficiencia humana (VIH) permite preservar la salud de las personas infectadas, pero no erradica el patógeno. La nueva iniciativa, desarrollada en los últimos dos años, fue presentada antes del inicio de la XIX Conferencia Internacional sobre el Sida que se celebrará del 22 al 27 de julio en Washington. Cerca de 25.000 participantes se esperan en esta reunión organizada por la AIS. La idea es movilizar a la comunidad científica, los gobiernos, el sector privado y los donantes en todo el mundo para acelerar los esfuerzos de investigación y conducir a una cura más rápida del sida, que mató una 35 millones de personas desde su aparición hace 30 años, dijeron los expertos. "Esta estrategia resulta de un esfuerzo de colaboración de 34 investigadores que se tradujo en una hoja de ruta para avanzar en la investigación hacia una cura de la infección por el VIH", dijo Francoise Barre-Sinoussi, Premio Nobel de Medicina por el descubrimiento del VIH, experta del Instituto Pasteur de París y futura presidente de la IAS. "La ciencia nos dice desde hace algún tiempo que ahora es realista poder curar la infección del VIH y que llegó la hora de aprovechar la oportunidad para tratar de desarrollar una forma de lograr una cura", afirmó. La "Estrategia Científica Global Hacia una Cura del VIH" aparece en la revista Nature Reviews Immunology de fecha 20 de julio. El plan centra sus esfuerzos en áreas clave, como las reservas donde el virus de inmunodeficiencia humana (VIH) se esconde en el organismo, y el pequeño número de personas en el mundo que parecen tener una resistencia natural a la infección. Entre los estudios más prometedores está el conocido caso de un estadounidense con VIH, Timothy Brown, conocido como el "Paciente de Berlín", quien recibió un trasplante de células madre por una leucemia, de un donante resistente al VIH, y sigue sin mostrar signos de la enfermedad varios años después. El donante procedía de un pequeño grupo de europeos nórdicos que carecen de una proteína en la superficie de los glóbulos blancos conocida como CCR5, que sirve como puerta de ingreso del VIH a las células.

18 Aunque un trasplante es demasiado arriesgado para ser considerado una opción para el público en general, la operación prueba que es posible hallar una cura funcional al sida. Otro grupo único de pacientes en Francia que se infectaron con el VIH, pero comenzaron el tratamiento temprano y pudieron detener la infección sin rebote viral. Sus sistemas inmunológicos están siendo intensamente estudiados. Para curar el sida estos científicos consideran desde la terapia génica hasta tratamientos inmunológicos y vacunas, utilizados de manera combinada y con terapias antirretrovirales para preparar a los sistemas inmunes de los pacientes. El costo de tratar a las personas con VIH (unos 34 millones en todo el mundo) "abruma a muchas organizaciones y sistemas de salud pública", indicó el artículo de la IAS. La ONU pidió 22.000 a 24.000 millones de dólares anuales para frenar la epidemia del sida para 2015, y los tratamientos antirretrovirales representan hasta 70% de esos fondos en las zonas más afectadas, según datos del artículo. "Se estima que por cada persona infectada con VIH que inicia la terapia antirretroviral, dos personas se infectan con el VIH, lo que es claramente insostenible", agregó la nota en Nature. Por eso son necesarios más fondos para investigar una cura de la enfermedad, y tener una estrategia para ello, opinó Barre-Sinoussi, quien aclaró no obstante que los recursos no deben sacarse de los programas actuales para tratar y prevenir la enfermedad. http://www.google.com/hostednews/afp/article/ALeqM5gY-8GIQYefD- FJBmVqcwb8eTCivA?docId=CNG.4cf9930026180e7a836d66dc7899d61b.4c1

Agence France-Presse (Spanish)

Presentan tres prometedores estudios con miras a la cura del sida

Tres estudios presentados el jueves en la XIX Conferencia Internacional del Sida en Washington dan a los científicos nuevas posibilidades para explorar en la búsqueda de una cura para la pandemia, que ya lleva tres décadas y afecta a unos 34 millones de personas en el mundo.

Jueves, 26 JUL 2012 - 18:03

Washington. AFP.- El estudio fue realizado en un grupo de 12 pacientes en Francia, que iniciaron el tratamiento con antirretrovirales a las 10 semanas de infectarse con el VIH, el virus de inmunodeficiencia humana que causa el sida, pero luego dejaron la terapia.

El virus del VIH se mantuvo a raya durante una media de seis años en este grupo, conocido como Cohorte de Visconti, acrónimo de "Estudios virológicos e inmunológicos en controladores después de la interrupción del tratamiento".

Este grupo de personas no eliminó por completo el VIH, pero siguió teniéndolo a un nivel extremadamente bajo en sus células y no se enfermó de sida.

"Estos resultados sugieren que el tratamiento antirretroviral debe iniciarse muy temprano después de la infección", dijo Charline Bacchus, investigadora principal del estudio de la ANRS, la agencia nacional de investigación del sida en Francia.

"Seis años después de la interrupción del tratamiento, los pacientes tratados tempranamente tras la infección tuvieron la capacidad de controlar la infección del VIH".

Los científicos continúan estudiando las características inmunológicas de este grupo en busca de pistas acerca de por qué ellos no necesitan medicación prolongada. La mayoría de los pacientes con VIH deben tomar antirretrovirales de por vida.

El segundo estudio presentado en Washington involucró a dos hombres con VIH que no mostraron ningún rastro del virus a los ocho y 17 meses, respectivamente, de recibir trasplantes de células madre de un donante externo debido a una leucemia.

Sus casos son diferentes al famoso "paciente de Berlín", un estadounidense que se considera curado del VIH y de leucemia después de recibir trasplantes de médula ósea similares de un raro donante que poseía una resistencia natural al VIH (carecía del receptor CCR5 que actúa como puerta de ingreso del virus a las células).

20 Estos dos hombres recibieron trasplantes de donantes con el receptor CCR5, por lo que no lograron una protección natural contra el virus.

Según los investigadores, al continuar el tratamiento de ambos hombres con antirretrovirales durante el proceso, el medicamento impidió que las células del donante se infectaran hasta ser capaces de proporcionar a los pacientes con nuevas defensas inmunitarias.

El estudio fue presentado en la Conferencia Internacional del Sida por Daniel Kuritzkes, profesor de medicina del Hospital Brigham and Women, en Massachusetts (noreste de Estados Unidos).

Un tercer estudio sobre cómo un medicamento contra el cáncer ayudó a eliminar el VIH de las células de los pacientes fue presentado por David Margolis de la Universidad de Carolina del Norte (este).

Los investigadores usaron el medicamento de quimioterapia vorinostat para revivir y así desenmascarar el VIH latente en las células CD4+ T de ocho pacientes que también estaban tomando antirretrovirales para detener la multiplicación del virus.

Margolis, cuyo estudio fue publicado el miércoles en la revista británica Nature, dijo a los periodistas que la comunidad científica mira con entusiasmo la posibilidad de hallar una cura para el VIH, incluso aunque la solución parece estar a años de distancia.

"No puedo decir cuánto tiempo va a llevar", dijo. "Pero creo que hay un camino claro y podemos avanzar". http://www.lanacion.com.py/articulo/82917-presentan-tres-prometedores-estudios-con-miras-a- la-cura-del-sida.html

Agence France-Presse (Chinese)

愛滋可望有解科學家籲抓良機

(AFP) – 14 小時前

（法新社華盛頓 19 日電）國際科學家今天呼籲推動新一波愛滋病（AIDS）治癒方法。科學家表示，這個發現 30 年的傳染病，擴散速度快過藥物。

這項 7 步驟的科學策略著重在關鍵領域，像是愛滋病毒（HIV）在人體的藏身處，以及全球各地似乎對 HIV 有天然抵抗力的少數人。

這項計畫發表在英國「自然」（Nature）期刊，並在美國華府的新聞記者會上討論。華府將在 22 日至 27 日舉辦國際愛滋病研討會（International AIDS Conference），預計有 2 萬 5000 名專家與倡議人士與會。

聯合國愛滋防治計畫（UNAIDS）執行主任希迪貝（Michel Sidibe）說：「找出愛滋病解藥，是關鍵的創新缺口。」

根據文章背景資訊，聯合國呼籲在 2015 年以前，每年投入 220 億至 240 億美元協助抑止愛滋病，多達 70%經費要用在最嚴重地區的抗反轉錄病毒治療。

報告還說：「根據估計，每位 HIV 病患展開抗反轉錄病毒藥物治療的同時，就又新增 2 名 HIV 感染病例，這顯然讓經費無以為繼。」

鑑於此，HIV 共同發現者、巴黎巴士德研究所（Institut Pasteur）轉錄病毒感染管制部門主任巴瑞西諾希（Francoise Barre-Sinoussi）表示，研究愛滋病治癒方法的研究人員反而需要更多經費，並重新將焦點放在愛滋病的治療路徑圖。

巴瑞西諾希說：「如今科學告訴我們，找出 HIV 感染解藥在現實生活是可能的。現在正是把握機會研發 HIV 解藥的大好時間點。」（譯者：中央社陳怡君）1 Copyright © 2012 AFP。版權所有。更多資訊 » http://www.google.com/hostednews/afp/article/ALeqM5h-dFc6ec4toC65uKySu- 7xwKNNXA?docId=health0001.120720092007

Agencia EFE (Spain)

Un equipo médico anuncia la cura de dos hombres con VIH tras un trasplante de médula

Efe | Washington Actualizado viernes 27/07/2012 04:04 horas

Dos personas podrían haberse curado del VIH después de haber sido sometidas a un trasplante de médula ósea para tratar un cáncer, según un estudio difundido en la XIX Conferencia Internacional sobre el Sida que se está celebrando en Washington.

La investigación, liderada por el doctor Daniel Kuritzkes, del Brigham and Women'’s Hospital (en Massachusetts, EEUU), analizó la evolución de dos pacientes infectados de sida que se sometieron a un trasplante de médula ósea tras haberles sido detectado un cáncer. En esta ocasión, no se buscaron donantes con resistencia al VIH como sucedió en el caso deThimothy Brown, primer paciente al que se considera curado de VIH.

Los dos hombres, infectados durante años, se habían sometido a la terapia antirretroviral que suprimió por completo la reproducción del VIH, aunque aún tenían reservorios de virus latente antes del trasplante. Antes de someterse al trasplante, ambos pacientes recibieron una forma más leve de quimioterapia, lo que les permitió continuar con sus medicamentos para el VIH durante todo el proceso de la operación.

Según el estudio, los médicos detectaron el VIH inmediatamente después del trasplante, pero, con el tiempo, las células trasplantadas sustituyeron a los linfocitos propios de los pacientes, y la cantidad de VIH en el ADN de sus células disminuyó hasta el punto de que se hizo indetectable. "Esperábamos que el VIH desapareciera del plasma de los pacientes; pero es sorprendente que no podamos encontrar ningún rastro del VIH en sus células», ha destacado Timothy Henrich en la presentación de los resultados. "El siguiente paso consistirá en determinar si hay rastro de VIH en sus tejidos", comentan los expertos.

Uno de los pacientes fue sometido a seguimiento médico durante casi dos años después del trasplante y el otro durante tres años y medio, y "no hay rastro del virus", según ha informado la organización en un comunicado.

Brown, el precedente Ambos casos recuerdan al de Timothy Brown, conocido como 'el paciente de Berlín', que dejó de tomar los antirretrovirales para someterse a un complicado tratamiento con células de un donante

23 para combatir una leucemia mieloidea. Posteriormente, su organismo no dio nuevos signos de VIH pese a no volver a tomar los fármacos antiVIH. No obstante, los expertos señalan que, a diferencia de Brown que recibió células madre con una mutación en el receptor CCR5 -necesario para que el virus se propague por el organismo-, los dos pacientes del estudiorecibieron células comunes.

Gracias a la eficacia de la terapia antirretroviral continua, las células que repoblaron el sistema inmune de los pacientes parecen estar protegidas de ser reinfectadas por el virus, 'una información muy importante', señalaron los expertos.

Aún así, los médicos se mantienen cautelosos y, a la pregunta de si podrían considerar que los pacientes están curados, Kuritzkes señaló que "estamos siendo muy cuidadosos en no hacer eso", según declaraciones recogidas por el canal de televisión MSNBC. De momento, los dos hombres están tomando fármacos antirretrovirales hasta que se les puedan ir retirando bajo condiciones experimentales.

Apuesta por la innovación "No estamos diciendo: Son como el 'paciente de Berlín'", señaló Kuritzkes. Los dos pacientes no han sido identificados por razones de privacidad pero, según MSNBC, uno de ellos está en la cincuentena y fue infectado en la década de 1980, mientras que el otro tiene 20 años y fue infectado al nacer.

"Las palabras no pueden comenzar a expresar mi alegría de que otros dos hombres puedan haber sido curados de VIH", señaló Brown, hasta ahora el único paciente considerado curado de VIH, y que acaba de lanzar su propia fundación para buscar una cura al sida.

"Esto refuerza mi determinación y la convicción de que debemos cumplir con la misión central de mi fundación de invertir en terapias de vanguardia y tratamientos para avanzar en la investigación de la cura del sida", dijo en un comunicado. Brown expresó su deseo de que "todo el mundo se cure" y espera que estos nuevos casos "representen el comienzo del fin de esta plaga". http://www.elmundo.es/elmundosalud/2012/07/27/hepatitissida/1343354388.html?cid=GNEW 970103

Asian News Service

2 HIV patients undergo bone marrow transplants

ANI | Jul 27, 2012, 03.24PM IST

Two HIV-positive patients no longer have detectable HIV in their blood cells after they underwent bone marrow transplants, according to researchers at Brigham and Women's Hospital in Boston.

The virus was easily detected in blood lymphocytes of both men prior to their transplants but became undetectable by eight months post-transplant.

The men have remained on anti-retroviral therapy.

Timothy Henrich, MD and Daniel Kuritzkes, MD, physician-researchers in the Division of Infectious Diseases at BWH, presented their cases at the International AIDS Conference.

"This gives us some important information. It suggests that under the cover of antiretroviral therapy, the cells that repopulated the patient's immune system appear to be protected from becoming re-infected with HIV," said Dr. Kuritzkes.

One patient's bone marrow transplant was two years ago, the other was four years ago. Both were performed at the Dana-Farber/Brigham and Women's Cancer Center.

Over time, as the patients' cells were replaced by donor cells, traces of HIV were lost. Currently, both patients have no detectable HIV DNA or RNA in their blood. The level of HIV antibody, a measure of exposure to HIV, also declined in both men.

"We expected HIV to vanish from the patients' plasma, but it is surprising that we can't find any traces of HIV in their cells. The next step is to determine if there are any traces of HIV in their tissue," said Dr. Henrich.

The research team is currently designing studies that would enable them to look for HIV in the tissues. Researchers also plan to study additional HIV-positive patients who have undergone a bone marrow transplant.

Researchers point out that there are two key differences between the Brigham patients and the "Berlin patient", a man who was functionally cured of HIV after a stem cell transplant.

25 In the Berlin patient's case, his donor was specifically chosen because the donor had a geneticmutation that resisted HIV. The Brigham patients' bone marrow transplants were done without any thought to selecting an HIV-resistant donor. Second, the Berlin patient ceased anti-retroviraltherapy after his transplant, while the Brigham patients have remained on anti-retroviral therapy. http://timesofindia.indiatimes.com/life-style/health-fitness/health/2-HIV-patients-undergo-bone- marrow-transplants/articleshow/15199548.cms

Associated Press 2 more patients 'free of HIV' after bone marrow transplants

Published July 27, 2012

The HIV virus of two more patients has been suppressed, thanks to a bone marrow transplant, the Boston Globe reported.

Timothy Ray Brown, also known as the ‘Berlin patient,’ underwent a bone marrow transplant in 2007 to treat leukemia, using a donor with a rare gene mutation that provides natural resistance to HIV. Doctors declared him "cured" soon after. These two new patients were also seeking treatment for cancer, according to the newspaper.

And although researchers in California recently found traces of HIV in his tissues. Brown said any remnants of the virus still in his body are dead and can't replicate.

Scientists from Brigham and Women’s Hospital and Harvard were careful not to use the word ‘cured’ while presenting at the 2012 International AIDS Conference; but experts are hopeful this provides insight that will lead to a possible cure one day.

“These researchers have done some elegant work, and found results that I think are going to be very provocative,” said Dr. Steven Deeks, an HIV researcher at the University of California, San Francisco.

Approximately eight months after the transplants, doctors said the patients’ blood did not show any trace of HIV infection.

“They went from this easily measured amount in their blood to no measurable amount in their cells,” said Dr. Daniel Kuritzkes of Brigham and Women’s Hospital. “We frankly didn’t expect that.”

However, Dr. Jay Levy, an HIV researcher at UC San Francisco, said that for some other patients, there are antiretroviral therapies that work so well, the virus virtually disappears. Other experts wondered if the virus could be living in the patients’ lymph nodes or bowels, which is harder to detect.

Also, these new patients do not have the protective gene mutation in their donor cells that Brown had received, so the transplants were given with antiretroviral therapy. http://www.foxnews.com/health/2012/07/27/2-more-patients-free-hiv-after-bone-marrow- transplants/

Associated Press

AIDS specialists release 'road-map' for HIV cure

Published July 20, 2012

For years it seemed hopeless. Now the hunt for a cure for AIDS is back on.

International AIDS specialists on Thursday released what they call a road map for research toward a cure for HIV - a strategy for global teams of scientists to explore a number of intriguing leads that just might, years from now, pan out.

"Today's the first step," said French Nobel laureate Francoise Barre-Sinoussi, co-discoverer of the HIV virus who also co-chaired development of the strategy.

"No one thinks it's going to be easy," added strategy co-chair Dr. Steven Deeks of the University of California, San Francisco. "Some don't think it's possible."

The announcement came just before the International AIDS Conference begins on Sunday, when more than 20,000 scientists, activists and policymakers gather in the nation's capital with a far different focus: how to dramatically cut the spread of the AIDS virus, what they call "turning the tide" of the epidemic, using some powerful tools already in hand.

Chief among them is getting more of the world's 34 million HIV-infected people on life-saving medications, so they stay healthier and are less likely to infect others. By itself, that is a huge hurdle. Just 8 million of the 15 million treatment-eligible patients in AIDS-ravaged poor regions of the world are getting the drugs.

But Barre-Sinoussi, president-elect of the International AIDS Society, which hosts the conference, said that lifelong treatment, as good as it is, isn't the end-all solution - and that science finally is showing that a cure "could be a realistic possibility."

The panelists refused to estimate Thursday how much this research would cost. But already, the National Institutes of Health has increased spending on cure-related research, about $56 million last year, according to a report in this week's issue of the journal Nature. Scientists attempting cure research will meet Friday and Saturday, ahead of the AIDS conference, to compare notes. And the new strategy won praise from Michel Sidibe, executive director of UNAIDS, the Joint United Nations Program on HIV and AIDS.

"The previous generation fought for treatment," he said. "Our generation must fight for a cure." Today's anti-HIV drugs can tamp down the virus to undetectable levels - but they don't eradicate it. Instead, tiny amounts of the virus can hide out in different tissues and roar back if medication is stopped.

28 That means there's no certainty of developing a cure.

"I'm not sure we can, but we're going to try," Dr. Anthony Fauci, director of NIH's National Institute of Allergy and Infectious Diseases, said in a recent interview. "This virus is uncanny in its ability to be able to integrate itself into a cell, as a reservoir, and no matter what we've done so far, we have not been able to eliminate that reservoir."

Yet one person in the world apparently has been cured: Timothy Ray Brown of San Francisco, who in 2006 was living in Berlin when in addition to his HIV, he got leukemia.

Brown underwent a blood stem cell transplant - what once was a bone marrow transplant - to treat the cancer. His own immune system was destroyed. And his German transplant surgeon found a donor who was among the 1 percent of whites who have a gene mutation that makes them naturally resistant to HIV - their cells lack the specific doorway the virus uses to get inside.

It worked. Brown has been off HIV medications for five years and is doing well, Deeks said Thursday.

That dangerous and expensive transplant isn't a practical solution, but it has sparked a variety of research into other possible ways to eradicate HIV. Already, 12 early-stage studies involving small numbers of patients - fewer than 200 people worldwide - are under way, the international panel said Thursday. Results to see if any are promising enough to pursue should be out in the next year or two.

The priorities of the new cure research strategy: -Determine why HIV hibernates and persists.

-Learn why some people are naturally resistant. In addition to that 1 percent of people with the gene mutation, researchers now are studying a small group of patients in France who started medication soon after they were infected and many years later were able to stop the drugs without the virus rebounding.

-Develop and test strategies to make HIV patients more naturally resistant. Already gene therapy studies are under way to knock that HIV doorway out of people's own infection-fighting blood cells.

-Learn where all those secret reservoirs are.

-Develop strategies to attack the reservoirs. One new attempt uses drugs to wake up the dormant HIV so the immune system can spot and attack it, what Deeks called the "shock and kill approach." Last spring, University of North Carolina, Chapel Hill, researchers reported that a drug normally used for lymphoma made some latent HIV rapidly detectable in six patients. Deeks has a similar study under way using an old anti-alcoholism drug.

-Develop good tests to measure these tiny amounts of dormant HIV, crucial to telling if any cure attempts are promising short of taking patients off their regular medication. http://www.foxnews.com/health/2012/07/20/aids-specialists-release-road-map-for-hiv-cure/

Australia Associated Press

Aussie research part of HIV cure effort

BY MICHELLE HENDERSON, AAP NATIONAL MEDICAL WRITER From:AAP July 20, 2012 5:09AM

AUSTRALIAN researchers hope a trial underway in Melbourne will reveal a way to stamp out HIV for good.

The research at The Alfred hospital, Monash University and Burnet Institute is part of a global effort to find a cure for the virus, which comes under the spotlight next week at the International Aids Conference in Washington.

About 20 HIV-positive patients in Victoria will test the ability of a drug to 'wake up' the virus in cells where it hides and lies dormant, away from the reach of current anti-HIV drugs.

The theory, says The Alfred's Infectious Diseases Unit director Professor Sharon Lewin, is that the reawakened virus would kill the cell it inhabits, thereby self-destructing.

Prof Lewin, who is also co-head of virology at Melbourne's Burnet Institute, said the study's results should be available later this year.

"We know from the first 10 patients that the treatment was safe and relatively well tolerated and didn't cause any harm to people," Prof Lewin told AAP. "Now we are doing the more detailed studies to see whether we have woken up the virus." This particular approach to a cure, one of a handful worldwide, is based around the way the HIV virus behaves.

Anti-HIV drugs are unable to completely eradicate the virus because it burrows deeply into the DNA of immune cells, especially in the lymph nodes or gut, where it gets stuck and goes to sleep. Prof Lewin's team tested a treatment belonging to a group of drugs called histone deacetylase inhibitors. The drug, Vorinostat, is one of two in the group already licensed to treat cancer. The theory worked in earlier laboratory tests but it remains to be seen if it works in HIV patients. Unlike other more expensive approaches to a cure, Prof Lewin's therapy involves simply taking a tablet, making it a potentially affordable option to target the disease where it hits hardest - in poorer countries.

Prof Lewin said the impetus to find a cure lay in the huge economic cost of keeping infected people on antiretroviral drugs for life.

"Antiretroviral drugs are very effective," she said.

30 "They substantially reduce mortality and also make a person less infectious. But they cost a lot and treatment is currently lifelong."

Although the cost of supplying antiretroviral drugs to the more than 34 million people living with HIV has decreased significantly, it is still overwhelming many organisations and public health systems.

The cost of funding the HIV/AIDS epidemic has been estimated at between $22 billion to $24 billion by 2015 and up to $35 billion per year by 2031.

Antiretroviral treatment is expected to account for up to 70 per cent of the total cost of care in the most affected countries.

Initially, a cure for HIV was thought impossible but a remarkable case referred to as the 'Berlin patient' proved otherwise.

The American HIV patient Timothy Brown was living in Berlin in 2007 when he was given a lifesaving stem cell bone marrow transplant to treat leukaemia.

The bone marrow was from a donor with a rare genetic mutation that eliminates a protein called CCR5, found in about one per cent of northern Europeans.

HIV needs CCR5 to enter a cell, so a patient with a mutation in CCR5 is effectively protected from infection with HIV.

The Berlin patient was cured of HIV and remains off antiretroviral drugs.

Bone marrow transplants for HIV patients had been considered far too risky but the case provided the basis to use gene therapy to modify patient's cells to become resistant to HIV, Prof Lewin said. Scientists have successfully achieved this in the laboratory by removing CCR5 and clinical trials are now underway to test the hypothesis further.

The California Institute of Regenerative Medicine, headed by Australian stem cell expert Professor Alan Trounson, is one institution developing a potential HIV cure based on this approach which is about to enter human trials.

Prof Trounson said if the trials were successful further research would be needed to modify the technology so it could be affordably used where it is needed most, in Africa. "I want the HIV work to go globally because it shouldn't be restricted to patients in Western (countries)," Prof Trounson told AAP.

"We're going to have to modify some of that further research to get it into a suitable treatment that we can use in Africa."

Another potential cure under investigation involves boosting the immune system to mimic a group of HIV patients who can control the virus naturally.

This group of patients, known as "elite controllers", have low levels of the virus which don't require drug treatment.

31 "That's made people think we could achieve something called a functional cure," Prof Lewin says. A global strategy to cure HIV was unveiled on Thursday in Washington ahead of the International Aids Conference.

The strategy comes after two years of work by a group of international experts, of which Prof Lewin is a member, to map out a research plan in pursuit of a cure. The International AIDS Conference will be held in Melbourne in 2014. http://www.theaustralian.com.au/news/breaking-news/aussie-research-part-of-hiv-cure- effort/story-fn3dxiwe-1226430510143

Bloomberg (USA)

AIDS Cure Seen Possible on Hint of Success With Merck Drug

July 25 (Bloomberg) -- A Merck & Co. drug for a rare type of cancer flushed out hidden deposits of HIV in a study, according to researchers who say the results provide a hint that curing AIDS may someday be possible.

The finding on Merck’s Zolinza, reported today in the journal Nature, comes as researchers at the International AIDS Conference in Washington this week express optimism a cure is on the horizon. While current treatments hold the disease at bay, stopping the drugs can be a death sentence since it allows infected cells that remain hidden within the immune system to re-emerge, spreading the virus anew.

A single dose of Zolinza reactivated the hidden cells in eight infected patients, a first step toward finding and eliminating all virus traces from the body, according to investigators at the University of North Carolina at Chapel Hill and Whitehouse Station, New Jersey-based Merck who undertook the research.

“If we ever have a cure for AIDS, a big part of it will be this type of strategy,” said Steven Deeks, a professor of medicine at the University of California, San Francisco, who wasn’t involved in the study. “It’s all about getting the virus out of the hiding place and coming up with a way to kill it.”

Over the last few years, drugmakers including Gilead Sciences Inc., Merck, and Johnson & Johnson have been quietly building up teams of researchers focused on developing ways to wipe out hidden reservoirs of the virus, said Romas Geleziunas, director of clinical virology at Gilead, in an interview at the conference.

‘Hottest Topic’

While the research remains years away from large-scale human testing, curing AIDS “is one of the hottest topics right now in biomedical research because there are finally ideas,” he said. “Pharma now is really behind this.”

Gilead has been working on AIDS cure research for three years, according to Geleziunas. The Foster City, California- based company, which makes the HIV treatments Atripla and Viread, has two approaches in laboratory testing. In one, Gilead scientists are working with academic researchers to test a lymphoma drug called Istodax from Celgene Corp. in a small HIV patient trial that could begin next year, said Geleziunas. If the trial shows promise, Gilead would then try to come up with an improved version. Celgene isn’t pursuing its own testing of the drug for HIV, spokesmanBrian Gill said in an e-mail.

33 A record 34.2 million people worldwide are living with HIV, the virus that causes AIDS, according to UNAIDS, the United Nation’s division devoted to treating and preventing the disease. It remains a killer disease globally, with about 4,000 deaths a day attributed to it last year alone, the data shows.

Chronic Disease Today’s drug cocktails have transformed AIDS into a chronic disease by preventing the virus from replicating. Yet they can’t cure the disease because the current medicines don’t kill HIV-infected cells. If a patient stops taking the drugs, the virus will eventually come roaring back, thanks to hidden deposits inside rare dormant blood cells.

In each patient, there are about a million of these infected cells, Geleziunas said. Finding a way to wake them up so they can be spotted and eliminated is a main goal of researchers sleuthing for a cure, he said.

“It is going to be a step by step slow battle, but we can see a way forward,” said David Margolis of the University of North Carolina at Chapel Hill, who led the Nature study and has been working for 18 years on ways to eliminate the hidden HIV virus deposits.

Early Trials There are now roughly 12 patient trials in early stages testing various approaches to curing the disease, said Sharon Lewin, a professor at Monash University in Melbourne, Australia, in an interview. At the AIDS meeting, she said she met with representatives from about 15 drug companies interested in cure research.

“There is quite a bit of research and I think that is new,” said Lewin, who is also conducting a patient trial of the Merck lymphoma drug in HIV patients.

At J&J, the world’s biggest maker of health care products, 15 researchers in Belgium are focused full-time on developing drugs that could lead to a cure, said Marie-Pierre de Bethune, a vice president in infectious diseases with J&J.

The researchers have taken 35,000 compounds from J&J’s library of experimental drugs and tested them against the virus in the lab to see which activate the dormant virus and make it reveal itself to the immune system, de Bethune said in an interview at the AIDS meeting.

Drug Combinations Researchers will likely have to combine several medications to kill off the hidden virus deposits -- one group to wake up the hidden cells and another that would then prompt the immune system to kill them.

“One drug isn’t going to do the trick to cure the disease and many approaches will be needed,” de Bethune said. So far, there is only one person who has ever been cured of HIV, Timothy Ray Brown -- the so-called Berlin Patient. His HIV was wiped out after getting a bone marrow transplant in 2007 for cancer. The donor had a rare gene mutation that made the new white blood cells resistant to infection with the AIDS virus.

34 “I am cleared of the AIDS virus,” Brown said at a news briefing on July 24 in conjunction with the International AIDS Conference. “It is my hope that my life and my story will inspire others to follow a path to a cure that will help everybody.”

Zolinza Study While a bone marrow transplant isn’t a practical solution for curing HIV for the masses, Brown “showed that scientifically it was possible” to cure a patient, said Margolis, senior author of the study on Merck’s Zolinza.

“Four years ago there was virtually nobody talking about eradication research publically,” Margolis said in an interview. Now “a lot of people are jumping in.”

When Margolis started working on hidden HIV reservoirs back in 1994, researchers weren’t even sure they existed. His first grant proposal on the subject was rejected, he said.

Margolis’s new study shows that Zolinza, a type of cancer drug called an HDAC inhibitor, can turn on the dormant immune system cells infected with the AIDS virus.

All eight patients were controlled on existing drugs, and remained on their regular therapy. They received one dose of Zolinza, and then had blood cells removed during a procedure called leukapheresis.

Laboratory tests of the cells found that the average virus expression in the dormant cells increased five-fold, indicating at least some of the virus was being driven out of its hiding places, the researchers wrote. Initial results of the Margolis study were presented at a conference in March.

‘Step Forward’ What isn’t clear from the study is whether the hidden HIV- infected cells were killed, Margolis said. They also don’t know what fraction of the hidden virus was activated.

Nonetheless, “this is an important step forward,” said Daniel Kuritzkes, chief of infectious diseases at Brigham & Women’s Hospital in Boston. “This is the first compelling evidence we have that we can induce virus expression from latently infected cells.”

Kuritzkes is studying additional bone marrow transplant patients infected with HIV to see if the transplants can sometimes wipe out virus reservoirs even if they aren’t from donors with cells resistant to HIV, like the cured patient Timothy Ray Brown. Initial results from this study are slated to be presented at the AIDS conference.

Prototype Drug Merck’s head of infectious disease research, Daria Hazuda, said she doubts Zolinza itself would be a drug that eradicates HIV. The strategy behind the trials is to use Zolinza as a prototype that could pave the way for more potent compounds that are better at flushing the HIV out.

The company has “dozens” of scientists working in the early stages of research on the problem, Hazuda said.

35 The goal is to come up with a combination therapy, much like current treatments for hepatitis C, that can cure a significant fraction of HIV patients over a treatment course that might last a month to a year, she said.

One factor driving the resurgence of interest in cure research is the failure to come up with an AIDS vaccine, according to Hazuda. In September 2007, a promising Merck AIDS vaccine failed in large- scale trials.

“It was a real jolt to the entire field,” when an experimental Merck AIDS vaccine failed in large patient trials in 2007, Hazuda said. “I think that woke people up with respect to thinking more serious about eradication and thinking more broadly about prevention research.”

Basic Research Research toward a cure “is still in the very primitive early basic science stages,” said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

He said it was important to pursue the studies aggressively even though the odds of success aren’t clear. The Bethesda, Maryland-based NIH has spent $122 million on HIV eradication research in 2010 and 2011, the agency said.

Other scientists are openly optimistic.

“Right now is probably the most hopeful and optimistic that we have ever been feeling about the possibility of a cure for HIV,” said Rowena Johnston, director of research for amfAR, The Foundation for AIDS Research.

“The chances are pretty good we will have a cure that will be applied widely in the next couple of decades,” UCSF’s Deeks said. http://www.sfgate.com/business/bloomberg/article/AIDS-Cure-Seen-Possible-on-Hint-of- Success-With-3735257.php#page-2

Reuters

Toward a cure for AIDS: Scientists set research agenda

By Julie Steenhuysen | CHICAGO | Thu Jul 19, 2012 5:23pm EDT

(Reuters) - A team of global scientists has devised a strategy to find a cure for AIDS, an effort inspired by the remarkable story of a single U.S. patient named Timothy Ray Brown who was cured from the disease.

Brown's treatment in Berlin involved the destruction of his immune system and a stem cell transplant from a donor with a rare genetic mutation that resists HIV infection. The procedure is too costly and too difficult to replicate on a large scale.

But in the years since his successful treatment in 2007, Brown's story has become a rallying point for scientists who believe the time is now right to seek a cure for AIDS.

Since the AIDS epidemic started 31 years ago, scientists have made great strides in treating the disease. AIDS-related deaths worldwide fell to 1.7 million last year from some 1.8 million in 2010, according to the latest report from United Nations AIDS program (UNAIDS).

Cocktails of powerful HIV drugs can keep the infection at bay for years, but the virus is wily, weaving itself into the DNA of special immune system cells, where it can lie dormant and out of reach of medications. That makes it necessary for HIV patients to take drugs over a lifetime.

As a result of better access to treatment, more patients with HIV are living near-normal lives, but the numbers of patients needing drugs is rising, increasing the future costs of AIDS treatment.

"Treatment is for life, and we know that it is important today and that it can slow the spread of the virus," said Michel Sidibé, executive director of UNAIDS.

But he said treatment should not be an end in itself.

"If we continue to believe it is the endgame, then we will have a challenge to get to 'zero,'" Sidibé said, referring to the goal of ending the epidemic.

"It's a first step," said Francoise Barre Sinoussi, who won a Nobel prize for her part in identifying human immunodeficiency virus. She is co-chair of the International Working Group Towards an HIV Cure, which released its proposed steps toward a cure on Thursday.

Sinoussi said the next step will be determining the cost-effectiveness of the strategy. That work will begin in conjunction with the International Aids Society's 2012 conference, which runs from July 22-27 in Washington.

GETTING RID OF THE VIRUS

37 Dr. Steven Deeks of the University of California San Francisco division of HIV/AIDS, who is co-chair of the working group, said health professionals see a growing need to "switch from blocking the virus to getting rid of the virus." Instead of trying to copy the treatment received by Brown, researchers will seek a similar response in a way that is less costly and easier to replicate.

Among the first tasks, according to Deeks, will be to continue basic research in the lab to understand why the virus persists in the body and where it hides out.

Scientists will also need to understand immune system function in HIV-infected patients and determine whether inflammation is playing a role in protecting the virus.

Other teams will need to determine why some patients develop antibodies to the virus, allowing them to control the infection, and whether this can be applied to the search for a cure.

Deeks said doctors need better tests to measure levels of the virus. Researchers will need to develop drugs that flush out the virus from its hiding places in the body, making it more vulnerable to treatment, as well as powerful medications to bolster the immune system's own ability to fight off infection.

Rowena Johnston, of the Foundation for AIDS Research, which is helping fund development of a cure, said the global strategy will help consolidate research efforts.

"Now that we know what the questions are, we can focus our efforts in the right direction," she said at a briefing announcing the new push.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Disease, a part of the National Institutes of Health, said his agency supports the work but that it is far too early to handicap its success.

"We still have so much discovery to do with regard to a cure that there's no guarantee when or if it will happen. We're sort of where we were over a decade ago with a vaccine," he said.

Back then, scientists were far less certain about vaccine prospects after repeated trial failures, but sentiment changed in 2009 with the first report in Thailand of a modestly successful HIV vaccine trial. "Now I can say, I'm confident that we'll get a vaccine, I just can't tell you when. With a cure, we're still at the very nascent phase of discovery," Fauci said.

(Additional reporting by Susan Heavey and Salimah Ebrihim in Washington; Editing by Michele Gershberg and Cynthia Osterman) http://www.reuters.com/article/2012/07/19/us-aids-cure-strategy-idUSBRE86I1JL20120719

SIPA Press (France) SIDA: une conférence à Washington pour "renverser le cours de l'épidémie"

WASHINGTON (Sipa) — "Renverser, ensemble, le cours de l'épidémie": l'objectif va mobiliser cette semaine plus de 20.000 chercheurs, militants d'ONG et responsables politiques, réunis à Washington pour la XIXe conférence internationale sur le SIDA. Mais certains scientifiques veulent aujourd'hui aller encore plus loin et relancer la quête d'un remède pour guérir la maladie, longtemps jugé inaccessible.

Pour l'heure, les participants de la conférence, qui s'ouvrait dimanche soir pour six jours, vont se concentrer sur les moyens d'endiguer définitivement la pandémie en utilisant certains des puissants moyens existants.

Premier défi à relever: faire en sorte que les 34 millions de personnes infectées par le VIH, le virus de l'immunodéficience humaine, aient davantage accès aux traitements qui permettent aujourd'hui de sauver des vies en limitant la progression de la maladie mais aussi de réduire les risques de transmission.

Or aujourd'hui, seuls huit des 15 millions de patients ayant besoin de ces antirétroviraux dans les régions pauvres du monde ravagées par le SIDA reçoivent ces médicaments coûteux qui permettent de vivre avec la maladie.

Pour autant, aussi bons soient-ils, ces traitements lourds, qui doivent être pris à vie, ne sauraient constituer l'objectif ultime, souligne Françoise Barré-Sinoussi, fraîchement élue présidente de la Société internationale du SIDA (International AIDS Society, IAS), qui organise la conférence. Pour cette chercheuse française de l'Institut Pasteur, prix Nobel de médecine 2008 avec son compatriote Luc Montagnier pour avoir découvert le virus du SIDA, les avancées de la science montrent désormais qu'un traitement pour guérir la maladie "pourrait être une possibilité réaliste". A l'approche de la conférence de Washington, le Pr Barré-Sinoussi et plusieurs autres spécialistes mondiaux du SIDA ont ainsi présenté jeudi une feuille de route pour atteindre cet objectif, jugé utopique pendant des années. Cette nouvelle stratégie veut permettre aux équipes internationales de chercheurs d'explorer un certain nombre de pistes susceptibles de déboucher sur une découverte majeure.

Les experts n'ont pas voulu pour l'heure estimer le coût de ces recherches. Mais déjà, aux Etats- Unis, les National Institutes of Health (NIH) ont accru les dépenses pour des recherches, avec environ 56 millions de dollars octroyés l'an dernier à ces travaux, selon un article paru cette semaine dans la revue scientifique "Nature".

"Aujourd'hui, c'est la première étape", a expliqué Françoise Barré-Sinoussi. "Personne ne pense que cela va être facile", a renchéri le Dr Steven Deeks, de l'université de Californie à San Francisco, qui a co-présidé avec la Française le développement de cette stratégie. "Certains pensent que ce n'est pas possible", a-t-il reconnu.

39 Les médicaments antirétroviraux peuvent aujourd'hui diminuer la charge virale jusqu'à des niveaux indétectables, mais n'éradiquent pas le virus. Pernicieux, ce dernier peut rester caché sous forme latente dans certaines cellules, sorte de réservoirs, et reprendre de la vigueur à l'arrêt du traitement.

Aussi rien ne dit qu'un remède puisse être trouvé un jour. "Ce virus est étonnant dans sa capacité à pouvoir s'intégrer dans une cellule, comme un réservoir, et malgré tout ce que nous avons fait jusqu'ici, nous n'avons pas été capable d'éliminer ce réservoir", soulignait récemment dans une interview le Dr Anthony Faucy, directeur de l'Institut américain de l'allergie et des maladies au sein des NIH.

Et pourtant, une personne dans le monde a, semble-t-il, guéri du SIDA, Timothy Ray Brown, le "patient de Berlin". Cet habitant de San Francisco, vivait à Berlin en 2006 quand, en plus du virus du SIDA, il a découvert qu'il souffrait d'une leucémie.

Pour lutter contre ce cancer, il a subi une greffe de moelle osseuse. Son propre système immunitaire était détruit. Et son médecin allemand a trouvé un donneur compatible qui faisait partie des 1% de personnes d'origine européenne présentant une particularité génétique qui les rend naturellement résistant au VIH. Il s'agit d'une mutation d'un récepteur, une molécule, qui constitue la porte d'entrée du virus.

Et cela a marché. Toute trace du virus a disparu. De fait, après cinq ans sans traitement anti-SIDA, le "patient de Berlin" se porte bien, a rappelé jeudi Steven Deeks.

Si la greffe de cellules souches sanguines, chère et dangereuse, ne peut constituer une solution à grande échelle en pratique, elle a suscité toute une variété de recherches sur d'autres moyens d'éradiquer le virus. Actuellement, 12 études préliminaires sur un petit nombre de patients, moins de 200 dans le monde, sont en cours, selon les experts. D'ici un ou deux ans, de premiers résultats devraient permettre de déterminer si elles valent ou non la peine d'être poursuivies.

La nouvelle stratégie de recherche fixe toute une série de priorités pour les scientifiques. Parmi elles, déterminer pourquoi le virus hiberne et persiste ainsi. Les chercheurs veulent aussi comprendre pourquoi certaines personnes sont naturellement résistantes. Outre le groupe qui présente une mutation génétique, une étude menée en France, l'étude "Visconti", porte sur un petit groupe de patients qui contrôlent leur infection. Ils ont entamé des traitements peu après avoir été contaminés et, quelques années plus tard, ont pu arrêter les médicaments sans que le virus ne progresse à nouveau.

Les scientifiques veulent aussi mettre au point et tester des stratégies pour renforcer la résistance naturelle des personnes infectées. Des études de thérapies géniques sont en cours. Autres pistes: déterminer où se trouvent les réservoirs secrets du virus et développer des moyens de s'attaquer à ces réservoirs. Des travaux utilisent des médicaments pour réveiller le virus latent pour que le système immunitaire puisse le repérer et l'attaquer.

Au printemps dernier, des chercheurs de l'université de Caroline du Nord à Chapel Hill, ont rapporté qu'un médicament utilisé normalement pour le lymphome avait permis de rendre le VIH latent rapidement détectable chez six patients. Le Dr Deeks conduit une autre étude similaire avec un vieux médicament utilisé contre l'alcoolisme.

40 Enfin, les chercheurs aimeraient développer des tests efficaces pour mesurer ces petites doses de VIH latent, un élément crucial pour déterminer l'efficacité de toute tentative pour guérir le malade. Sur le Net: www.aids2012.org sb/AP-v0/mw

(Sipa / 22.07.2012 18h56) http://www.romandie.com/news/n/SIDA_une_conference_a_Washington_pour_renverser_le_cours _de_l039epidemie220720121856.asp?

41 BROADCAST

CNN (USA)

Talk Of 'Cure' At Historic Aids Conference

By Saundra Young, CNN updated 10:59 AM EDT, Tue July 24, 2012

Washington (CNN) -- This week, the world's largest gathering of AIDS doctors and experts is converging on Washington for the 19th International AIDS Conference. It marks the first time in 22 years that the biannual event will be held on U.S. soil, possible only because a 25-year-old travel ban preventing HIV-positive people from entering the country was lifted by President Barack Obama in 2009 and went into effect a year later.

The significance of that move is not lost on researchers all over the country. More than 25,000 doctors, scientists, AIDS activists, politicians, philanthropists, drug company representatives, people living with HIV and heads of state from around the world are attending the weeklong conference.

42 There's a lot going on: research on how to prevent HIV infection, treatment as prevention and, for the first time in a long time, talk about a "cure."

In fact, one of the main themes is the launch of "Towards an HIV Cure": a global scientific strategy by an international working group of 300 researchers who are developing a road map of sorts, outlining priorities for finding a cure for the disease that has claimed approximately 30 million lives worldwide. Timeline: 30 years of AIDS -- Moments to remember

Their goal: figuring out why the virus lives indefinitely in certain cells, which tissues it lives in, how to get the immune system to kill it and what kind of drugs can get rid of it.

"We are trying to both inspire people about the possibility that this might happen someday but trying to be realistic, and the realistic part is that we have to do some fundamental basic science first," said Dr. Steven Deeks of the AIDS Research Institute at the University of California, San Francisco. "Most reasonable people would say it's at best 50-50 that we're gonna get a cure, so we don't want to over-hype this. We're excited, we think it's possible, we think it's worth pursuing, but don't expect anything in the near future."

Gay, bisexual men at high risk for HIV One man in particular, Timothy Ray Brown, has pushed the limits of possibility. He's known as the Berlin patient, the only person said to have been "cured" of HIV/AIDS. "I've been tested everywhere possible," said Brown, who now lives in San Francisco. "My blood's been tested by many, many agencies. I've had two colonoscopies to test to see if they could find HIV in my colon, and they haven't been able to find any."

In 2007, Brown, an HIV-positive American living in Berlin, was battling leukemia and needed a bone marrow transplant. His doctor searched for a donor with a rare mutation that makes it resistant to HIV. The transplant not only cured his cancer, it appears to have cured his HIV, because the virus is no longer detectable.

But Brown's case is rare. The procedure is extremely dangerous because a patient's immune system has to be wiped out in order to accept the bone marrow transplant. Using a bone marrow transplants to treat HIV is not a feasible treatment for most patients; only 1% of Caucasians -- mostly Northern Europeans -- and no African-Americans or Asians have this particular mutation, researchers say.

Quilt displays an American tragedy Last month, five years after Brows was "cured," reports surfaced that traces of the virus had been found in his blood. Deeks says that doesn't matter.

"Clinically, he has been cured. He stopped his drugs five years ago, his HIV tests are turning negative, we cannot find with standard measurements or even really super-sensitive measurements any virus anywhere, so from a clinical perspective, he is cured," Deeks said. "There's an academic debate as to whether every single virus is gone, but from Timothy's perspective, he shouldn't care."

43 Dr. Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, is one of the foremost experts on HIV and AIDS and believes that Brown's case is a "proof of concept" that the battle against the disease can advance beyond daily drug cocktails.

Deeks leads the global collaboration with Dr. Francoise Barre-Sinoussi of the Pasteur Institute in Paris, who was awarded the Nobel Prize in medicine for the discovery of HIV, along with her colleague Luc Montagnier. She says that by working together, they can get the job done faster.

"What we are sure is that we think it's reasonable today to say it's feasible to have a cure. A functional cure. I believe that if we work like in the early years of HIV, all together, we can move forward very fast as well for an HIV cure."

But what will a cure look like? There are two schools of thought. With a "functional" cure, the virus is controlled, and transmission would not occur. A "sterilizing" cure would eliminate the virus from the body entirely.

On Wednesday, Dr. David Margolis, an AIDS researcher at the University of North Carolina, Chapel Hill, is presenting results on a small study of eight patients treated with Vorinostat. It is used to treat lymphoma, a cancer of the lymph nodes and bloodstream.

"We just have to start doing these studies and trying to make progress, and I think the big change in the last few years is that you can talk about it now, and we can start to work on it seriously rather than doing the scientific work surreptitiously but not using the 'cure' word because everybody thought that was irresponsible or ridiculous."

Margolis says everything is on the table to try. "The assumption is, it's going to be complicated and difficult and involve multiple approaches, not 'take a pill and we're done.' "

French researchers are studying 12 HIV-positive people called the Visconti patients. According to Barre-Sinoussi, they were treated immediately after being exposed to HIV and have been able to control their virus naturally. Promising results from that study will also be presented.

"These patients have been treated very early on by the classical antiretroviral treatment during the acute phase of infections. They stopped their treatment, and now they are naturally able to control their infections with treatment anymore. They remain HIV-positive but they don't transmit to others, so it's also prevention." Researchers also hope to learn some important lessons from a group of infected men and women called elite controllers.

"They do not irradiate their virus," Barre-Sinoussi said. "But they are capable to naturally control their infection because they never receive any antiretroviral treatment. They have an undetectable viral load."

While small trials like these aim to find a cure, efforts to prevent infection have also made great strides. Last year, multiple studies showed that transmission of the virus can be reduced significantly -- up to 96% -- by giving antiretroviral drugs to the uninfected partners of people with the disease. It's called PrEP, or pre-exposure prophylaxis.

FDA approves Truvada for prevention of HIV/AIDS

44 For Barre-Sinoussi, all the pieces of the puzzle are important to future success, and she is hopeful of a cure in her lifetime.

Brown, who believes that he is cured, is banking on it.

"It means that this is a case in point that the disease can be cured. I don't wish what I went through on my worst enemy, but I'm hoping that it can be done in a more simple way, that can be translated to a cure for the entire world, all people that have HIV." http://www.cnn.com/2012/07/23/health/hiv-aids-conference/index.html

Agence France-Presse (English) Sida. La XIXe Conférence internationale s'est ouverte ce dimanche à Washington

23 juillet 2012 à 08h04

Au programme des six jours sera évoquée la possibilité de mettre fin, un jour, à la pandémie meurtrière du sida, voire éradiquer le virus (VIH) responsable de l'infection. Aujourd'hui dans les colonnes du Télégramme, Françoise Barré-Sinoussi dit son espoir. Lire également : > Sida. La fin de la transmission mère-enfant est "à portée de main", selon l'Unicef > Sida : le dossier de la rédaction > Un monde sans SIDA ? "Renverser la tendance de la pandémie pour parvenir à une génération libérée du sida" est le thème majeur de cette conférence qui se tient jusqu'au 27 juillet. 25.000 participants sont attendus

25.000 participants venus de plus de 190 pays sont attendus. Outre des chercheurs, des

46 personnalités politiques, du monde du spectacle et des militants anti-sida seront aussi présents. L'ancien président américain Bill Clinton, son épouse Hillary, la secrétaire d'Etat, Bill Gates, et le chanteur Elton John doivent y participer.

Les chercheurs estiment envisageable d'en finir avec le Sida Les chercheurs en pointe contre le sida estiment désormais envisageable, avec l'arsenal des traitements existants, d'en finir avec cette pandémie dévastatrice.

30 millions de morts en 30 ans La maladie a déjà fait 30 millions de morts depuis son émergence, il y a 30 ans. Actuellement 35 millions de personnes dans le monde vivent avec le virus du sida. 97% d'entre elles se trouvent dans les pays à revenus bas et intermédiaires.

"La science est de notre côté" "Nous pouvons dire aujourd'hui avec confiance que nous avons les bases scientifiques pour mettre fin à cette épidémie", a déclaré ce jeudi le Dr Anthony Fauci, directeur de l'Institut américain des allergies et des maladies infectieuses (NIAID). "Nous ne sommes pas sûrs de quand nous y parviendrons. Tout ce que nous pouvons dire c'est que la science est de notre côté".

L'attente d'une mobilisation plus forte des politiques "A la conférence de Washington on attend une mobilisation plus forte, en particulier des politiques, pour élargir l'accès aux traitements actuels et pour continuer la recherche", explique le professeur français, Françoise Barré-Sinoussi, co-lauréate du prix Nobel de médecine en 2008 pour l'indentification du virus du sida.  C. P., avec l'AFP

http://www.letelegramme.com/ig/generales/france-monde/monde/sida-la-xixe-conference- internationale-s-est-ouverte-ce-dimanche-a-washington-23-07-2012-1781367.php

Australian Broadcasting Corporation’s PM

Scientists hopeful of AIDS cure

Timothy McDonald reported this story on Wednesday, July 25, 2012 18:42:00

MATT PEACOCK: Leading AIDS researchers meeting in Washington say they're hopeful of finding a cure for AIDS, based on the remarkable stories of a few people who have managed to fend off the illness.

Scientists are discussing a number of approaches which would either eradicate the virus from the body, or coax the body to control the virus on its own.

Despite progress in anti-retroviral drug treatments, medical scientists say a cure is still needed, because the rate of HIV infections is outpacing the world's ability to treat people. But one Australian expert warns that it will be a long time before any of the ideas being discussed lead to clinical treatment options.

Timothy McDonald reports.

TIMOTHY MCDONALD: Roughly 34 million people are living with HIV globally.

Timothy Ray Brown isn't one of them, at least not any more.

TIMOTHY RAY BROWN: My blood's been tested by many, many agencies. I've had two colonoscopies and they've tested to see if they can find HIV in my colon and they haven't been able to find any.

TIMOTHY MCDONALD: In 2007 and 2008, he had two bone marrow transplants in Berlin to treat leukaemia, which was unrelated to his HIV infection. The blood cells for the transplants came from a donor with a genetic mutation, and they lacked the receptors HIV needs to gain entry to cells.

There's still some debate over whether some tiny traces of HIV might still be in his system, but he remains off retrovirals.

TIMOTHY RAY BROWN: Despite what you may have heard and I've read and heard recently in the media, I am cured of the AIDS virus.

TIMOTHY MCDONALD: He says his case is cause for celebration, and it could point the way forward.

TIMOTHY RAY BROWN: My case, my history is proof in concept that HIV can be cured.

TIMOTHY MCDONALD: Theory and practice, of course, are two very different things.

Professor Basil Donovan is from the Kirby Institute at the University of New South Wales.

BASIL DONOVAN: The Tim Brown case is just such a rare sequence of events. I mean it's equivalent of fixing your infected finger by chopping your arm of and then transplanting on a new arm. Basically he got rid of the virus by having his immune system totally destroyed through chemotherapy and then having bone marrow transplants from a donor that's naturally resistant to the virus.

TIMOTHY MCDONALD: Nevertheless, some researchers are hopeful that better treatments, or even a cure, are on the way.

Javier Martinez-Picado from Spain's AIDS Research Institute told Al Jazeera there's a number of avenues that researchers are pursuing.

JAVIER MARTINEZ-PICADO: So the other possibility would be trying to enhance the immune system and combine potent antiretroviral therapies with radioactivation therapies that may push the virus out of the cells and on the top of that help with some kind of immune-stimulation.

That would hopefully lead to the possibility that the patients may be living with some virus but not a big amount of virus in the blood and therefore being able to remove completely the antiretroviral treatment from their lives.

TIMOTHY MCDONALD: In addition to the unique case of Timothy Brown, research will also focus on a few hundred people known as 'elite controllers' who test positive for HIV, but who don't appear to have the virus in the blood.

A larger group of so called 'post-treatment' controllers are people who start therapy early and are able to stop its progress of HIV.

Details on a group of controllers in France are expected to be released at the meeting this week

Francoise Barre-Sinoussi is the director of the Regulation of Retroviral Infections Unit at the Pasteur Institute in Paris.

FRANCOISE BARRE-SINOUSSI: Now they're able to naturally control the infection without any treatment anymore.

49 TIMOTHY MCDONALD: Basil Donovan says controllers have been an area of research for quite some time. He warns that many of the ideas being discussed at the conference are a long way off, and even then, there's no guarantee they'll yield results.

BASIL DONOVAN: There are several avenues of defence. One would be some sort of hope of permanently suppressing the virus without ongoing treatment. There is research in that area; if you like resetting the system so that it can control the virus better.

There are strategies being investigated of stirring up all the active latent virus in the body and then killing it. All of these options are fairly dangerous; where you're sort of having to take the brakes off the immune system and let the virus replicate so that you can attack the virus.

At this stage, with current technology, this is pretty heroic medicine. I wouldn't rule it out but I wouldn't see any serious practical day-to-day treatments for at least a decade.

MATT PEACOCK: Professor Basil Donovan from the Kirby Institute and the reporter there was Timothy McDonald. http://www.abc.net.au/pm/content/2012/s3553588.htm

Australian Broadcasting Corporation

Global strategy to find AIDS cure

Tony Eastley reported this story on Friday, July 20, 2012 08:18:00

Audio Clip Available

TONY EASTLEY: For the first time since it was discovered in 1981 scientists from around the world have come up with a coordinated plan to try to find a cure for AIDS.

They unveiled their roadmap in Washington overnight and they say their prospects of finding a cure are "realistic".

Curing HIV/AIDS has taken a back seat in recent years as research has concentrated on improving the antiretroviral drugs which prolong life.

Australian researchers will play a key role in this renewed hunt for an AIDS cure.

One of them is professor Sharon Lewin, the director of the Infectious Diseases Unit at Melbourne's Alfred Hospital who spoke to me from Washington DC.

SHARON LEWIN: It's an international effort of 34 leading scientists. It's being led by Nobel Laureate Françoise Barre-Sinoussi who was awarded the Nobel Prize in 2008 for discovering HIV.

Francoise has really gathered together 34 of scientists who developed what they thought would be a roadmap to finding a cure for HIV.

Part of the process has involved extensive consultation with community, with governments, with funders, with regulatory bodies and other parties that will need to collaborate to eventually find a cure.

TONY EASTLEY: What sort of work will Australian scientists be asked to do under this new roadmap, this strategy that you talk about?

SHARON LEWIN: Yeah there's a lot of Australian scientists that are very actively involved in cure research. And that spans from very basic scientific studies of understanding how the virus persists and where it hides, particularly in a type of immune fighting cell and in the brain, as well as other approaches to eliminating this hiding virus.

And one approach is to essentially wake the virus up using drugs that turn the sleeping virus back on. And we in fact at the Alfred are doing a clinical trial of a drug that does exactly that in the test tube and now we're asking whether it can have that effect in patients.

TONY EASTLEY: It's almost an impossible question to answer but now you say scientists are getting

51 closer. How far away do you think a cure is?

SHARON LEWIN: I think what we're going to see in the next few years is a lot of new findings, new approaches to try and tackle persistent HIV largely driven by the enthusiasm of scientists but also increased funding which will accelerate the research.

Putting a time on it is extremely difficult. It's going to be challenging. We don't have a cure and that's because it's not going to be easy. But I think the investment and commitment by scientists as well as clinicians and funders will make a big difference over the coming years.

TONY EASTLEY: So many of you are getting together as part of this world strategy. It does pose the question, why wasn't it done earlier?

SHARON LEWIN: We've had a lot of challenges in battling HIV. The first challenge was back in the mid-80s, early 90s was simply to find a way to stop people dying. We've definitely found that and people now enjoy a very good quality of life.

The second big challenge has been getting drugs to people who need them. And we've also done a pretty good job of that with now over six million people in low income countries getting antiretroviral treatment.

We've had challenges of preventing new infections and we've had some real success stories in that arena with circumcision reducing new infections, treating people reduces their infectiousness.

So I think we have been fighting the battle on many fronts and this is really the next great challenge. And it's come at the right time I think because we really needed to get over those initial very significant challenges of the first 30 years of the epidemic.

TONY EASTLEY: Professor Sharon Lewin, the director of the Infectious Diseases Unit at Melbourne's Alfred Hospital speaking from Washington DC.

Australian Broadcasting Corporation

Scientists set agenda for AIDS cure

Updated 20 July 2012, 20:03 AEST

Scientists say the prospects for finding a cure for AIDS are realistic, after unveiling a roadmap to cure the disease.

This is the first time scientists have come up with a coordinated plan to tackle AIDS since the disease was discovered 31 years ago.

Approximately 34 million people around the world are HIV positive, and in 2010 more than 21,000 Australians were living with HIV infection.

Françoise Barré-Sinoussi, who won a Nobel prize for her part in identifying human immunodeficiency virus, is co-chair of the International Working Group Towards an HIV Cure, which released its proposed steps toward a cure overnight.

"It's a first step," Dr Sinoussi said, adding that the next step will be determining the cost- effectiveness of the strategy.

That work will begin in conjunction with the International Aids Society's 2012 conference, which runs from July 22-27 in Washington.

Professor Sharon Lewin, the director of the Infectious Diseases Unit at Alfred Hospital in Melbourne, says Australian scientists will also be actively involved in researching for a cure.

"Françoise really gathered together 34 of scientists who develop what they thought would be a roadmap to finding a cure for HIV," she said.

"The process has involved extensive consultation with community, with governments, with funders, with regulatory bodies and other parties that will need to collaborate to eventually find a cure."

According to Professor Lewin, the research will look at how the virus persists and where it hides.

53 Scientists will also need to understand immune system function in HIV-infected patients and determine whether inflammation is playing a role in protecting the virus.

Other teams will need to determine why some patients develop antibodies to the virus, allowing them to control the infection, and whether this can be applied to the search for a cure.

"One approach is to essentially wake the virus up using drugs that turn the sleeping virus back on," she said.

"At the Alfred [Hospital] we are doing a clinical trial of a drug that does exactly that in the test tube, and now we're asking whether it can have that effect in patients."

Challenging road ahead Since the AIDS epidemic started 31 years ago, scientists have made great strides in treating the disease. AIDS-related deaths worldwide fell to 1.7 million last year from some 1.8 million in 2010, according to the latest report from United Nations AIDS program (UNAIDS).

That makes it necessary for HIV patients to take drugs over a lifetime.

As a result of better access to treatment, more patients with HIV are living near-normal lives, but the numbers of patients needing drugs is rising, increasing the future costs of AIDS treatment.

Professor Lewin said the battle against HIV/AIDS has had a number of setbacks.

"The first challenge... was simply to find a way to stop people dying. We've definitely found that and people now enjoy a very good quality of life," she said.

"The second big challenge has been getting drugs to people who need them. We've also done a pretty good job of that with now over 6 million people in low income countries getting antiretroviral treatment.

"I think we have been fighting the battle on many fronts and this is really the next great challenge, and it has come at the right time."

ABC/Reuters http://www.radioaustralia.net.au/international/2012-07-20/scientists-set-agenda-for-aids- cure/983660

Radio France Internationale

2. Les avancées scientifiques sur le sida

Par Claire Hédon

Priorité santé est à Washington à l’occasion de la 19ème Conférence Internationale sur le sida. Cette Conférence rassemble des chercheurs, des médecins, des militants... En tout plus de 21 000 participants venus de 195 pays.

Les Etats-Unis n’avaient pas accueilli une conférence internationale sur le sida depuis 22 ans. Et pour cause, jusqu’en 2010, les personnes séropositives étaient interdites d’entrée sur le territoire américain. Barack Obama a mis fin à cette interdiction.

"Renverser la tendance de la pandémie pour parvenir à une génération libérée du sida" c’est le thème majeur de cette conférence. Effectivement, on sait ce qu’il faudrait mettre en place pour venir à bout de cette épidémie. car même si les traitements ne guérissent pas, ils permettent de contrôler la maladie et d’éviter de nouvelles contaminations. Mais dans un contexte économique difficile, comment trouver les financements pour mettre tous les patients sous traitement ? Peut-on réellement éliminer la maladie et aller vers la guérison du sida ? Quelles sont les points forts de cette conférence ?

Avec :  Pr Françoise Barré Sinoussi, Prix Nobel de médecine 2008. Directrice de recherche INSERM et Professeur à l 'Institut Pasteur où elle dirige l'Unité de régulation des Infections rétrovirales et des 2 jours Présidente de l’IAS.

 Bertrand Audoin, Directeur exécutif de l’International AIDS Society (organisateurs de la conférence).

 Pr Dorothée Gazard, ministre de la santé du Bénin.

 Dr Charles Kouanfack, MD, PhD, Chef de service Hôpital de Jour à l’Hôpital Central de Yaoundé au Cameroun.

http://www.rfi.fr/emission/20120725-2-avancees-scientifiques-le-sida-0

NPR’s Talk of the Nation

Researchers Renewing Focus On AIDS Cure

July 24, 2012

For much of the 31-year story of the AIDS epidemic, it was virtually taboo to use the word "cure." Now, after decades of focus on prevention and treatment, Deeks and other researchers say that it's time to put new emphasis on the search for a cure.

NEAL CONAN, HOST: Since the early years of the AIDS epidemic, talk of a cure became almost taboo. In the past few years, advances in prevention and treatment became increasingly effective. Now some researchers say it's time to shift focus and resources to finding a cure. So why now, what's changed, and how close are we? If you have questions about the search for a cure for HIV/AIDS, give us a call: 800-989-8255. Email us: [email protected]. You can join the conversation on our website as well. That's at npr.org.

Dr. Steven Deeks is a professor of medicine at the University of California, San Francisco, co-chair of the International AIDS Society's working group toward an HIV cure. He's in Washington for the International AIDS conference this week, just across the street. He joins us here in Studio 3A. Thanks for coming across.

DR. STEVEN DEEKS: You're welcome.

CONAN: And until recently, researchers - cure is - I think has been described as the C-word in the HIV context.

DEEKS: Yup. No, things have changed dramatically over the past couple of years. CONAN: What's changed?

DEEKS: Well, I think there are three things that have happened. One, I think the community, the scientists, clinicians, treatment advocates, patients, have become to realize that the current approach, which involves controlling the virus - not killing the virus but controlling the virus - works great, but there are issues. In order to - for people to live a long time, they have to take these

56 drugs every day, day in, day out, for decades and decades. And for lots of reasons, people - adherence, toxicity, cost - it's just hard for a lot of people to do that. And so we're thinking that rather than simply controlling the virus, we'd like to go in and kill the virus and get rid of the virus. So that's the first thing. There's a strong motivation to do this. Real quickly, the two other things that have happened have been that the science has advanced to where we think it may be possible. And, of course, there is the so-called proof of concept, Mr. Timothy Brown, the Berlin patient, well-known to many, who underwent a very aggressive bone marrow transplant about five years ago...

CONAN: Nothing to do with his HIV? DEEKS: No, no. So the - Mr. Brown, the Berlin patient, was doing well on therapy about five years ago, developed leukemia, and underwent a bone marrow transplant that was a little bit unique. And as a consequence, he appears to be cured. CONAN: And this, again, discovery completely off-kilter from any research that anybody was doing, but it does show promise?

DEEKS: It depends on what you mean by promise. This is not something that's going to happen many times in the future. What Mr. Brown went through was complicated. He almost died on a couple occasions. He was in and out of the hospital for a few years. It's not the kind of thing you want to do for your HIV. It was done for his leukemia. But they just did this little twist in the procedure. Rather than transplanting bone marrow from a typical person, they found bone marrow from these very rare individuals who are naturally resistant to getting HIV. And they transplanted that bone marrow into Mr. Brown. Mr. Brown stopped his drugs. The virus never came back. CONAN: And there are others - there are two elements to this, as I understand it. There are others who have been found with at least one element, and they seem to be more resistant than most to HIV.

DEEKS: So you're talking now about other transplants?

CONAN: No, not other transplants. People who have this condition naturally.

DEEKS: Oh, yes. No. So there is. And we've known this for a couple of decades now, that there is a small subset, maybe about one in a hundred people, who were born with the capacity not to resist the virus but to control the virus. These people are referred to, unfortunately, as elite controllers. I mean, that's sort of the name that stuck. They sort of are the best in terms of what happens in long- term HIV infection. But they acquire the virus. The virus is there. It can replicate. It's a bad virus, but their immune system somehow takes over and controls it and controls it indefinitely. And we've known about this for quite some time, and we think it's because they have these very powerful so-called killer T-cells that are able to identify the virus and kill it. Problem has always been that we've never been able to find a way to translate that information into other people. We've never been able to use that to come up with a new clinical strategy for cure, for treatment purposes.

CONAN: And does the Berlin patient, does Timothy Brown, does he offer the prospect, this avenue of developing something that is, as you say, less risky than a bone marrow transplant?

DEEKS: Well, the trick with Mr. Brown is that the stem cells that were transplanted lacked something called CCR5. CCR5 is the door by which the virus gets in the T cells. There are a number of groups that are coming up with novel ways to get rid of CCR5 genetically. And there's one group in particular - a couple groups, actually - who have developed these so-called molecular scissors

57 that actually go into the cell, cut up CCR5, and in theory, could, in a much safer way, do for someone else what happened to Mr. Brown. But that's years off, and it's sort of science fiction now. But at least there is a pathway by which I think we can get there. CONAN: And as you know, one of the reasons the C-word, cure, was avoided for so long was a concern that if people were talking about a cure, other people may say: Oh, cure? I guess I can go back to the kind of risky behaviors that got people this disease in the first place.

DEEKS: You know, I think that's what people were concerned about, and that was a concern in the late '90s, when these first studies first started occurring. But to be honest, I don't think that's played out. I think most people who are involved in this effort realize that this is maybe not a pipe dream anymore. It's a possibility, but it's a far way off. And at the end of the day, it's almost always going to be better to have never gotten HIV than to have gotten HIV, dealt with the virus for a while, and then gotten cured.

CONAN: And one question about resources: Is this search for the cure - how much is going - being devoted in terms of money, in terms of medical research? And is this - could this, some people say, be a distraction from other efforts for prevention and treatment?

DEEKS: This is always an issue. The NIH, which has been the largest funder of this type of research in the past, their budget has been basically flat for many years. But despite the fact that their budget has been flat, the NIH leaders have been able to identify, actually, I think a good amount of funding for this work, about $50 million last year for cure work. And this happened very quickly. And this happened without any controversy. I think that the field in general has recognized that this is worth the investment, and so this money has been shifted around from research and other areas into cure work without much of a controversy. And I think that's all good. And the hope is, is that in the future, we will be able to identify more funding within the NIH, but preferably without - outside the NIH, novel areas of funding.

CONAN: Our guest is Dr. Steven Deeks of the University of California, San Francisco and the International AIDS Society's working group Toward an HIV Cure. Let's get Curtis on the line. Curtis is on the line with us from Sacramento.

CURTIS: Yeah. Doctor, the question I had was the relationship between the Berlin patient and the early diagnoses of AIDS as gay leukemia. Symptomatically, is that relationship maybe what might be helping the Berlin patient with his success? And then that brings me to a second question, which is: Is it possible that there are two different types or strains of AIDS that one treatment might work for and others may not?

DEEKS: Well, the HIV can cause certain types of cancers, not necessarily leukemia so much as lymphoma. But I'm not sure that the connection between the early error in how HIV was discovered and today is relevant. Now, with regard to strains, one of the key problems we've always had with HIV is that there are many, many strains within - even with an individual, the virus evolves and changes and so forth. And yes, it certainly is possible that some of the interventions that we're pursuing will work for some virus families or strains and not others, but we're not there yet.

CONAN: Thanks for the call, Curtis.

CURTIS: You're welcome.

58 CONAN: Let's go next to - this is - and we're trying to get the - all right. Well, I'll deal with that in just a minute. As you look down towards this pipe dream - this possibility, no longer a pipe dream, but a possibility, what do - does the outlines of a cure look clear to you?

DEEKS: Well, there are two broadly defined ways to go about this. One is to do the gene therapy stuff. And to be honest, that's the most promising. I think that there is enough progress - the Berlin patient, new ways to go with gene therapy - that we could, if we really wanted to, cure more people with this aggressive way. And that's moving forward. But what people really want, what's going to really change the whole world in terms of HIV is something that is more affordable, that's safer, that's scalable, that could be done in my hometown, San Francisco, as well as in rural areas of Africa and elsewhere. Now, what would that look like? We don't know yet. It's just beginning. But in theory, a strategy that involves, number one, getting the virus out of its hiding place. The reason we can't cure things now is because the virus hides in these cells, and no one can get to it with the immune system or drugs. So the first thing will be getting the virus out of its hiding place. And there are some really exciting data coming out in the next couple of days about that approach. And two, to come up with a way to kill not the virus so much, because current drugs that we do take care of the virus when it comes out, but to come up with a way to kill the reservoir, the cells that contain this hidden virus. And we'll do that once the hidden virus becomes unhidden with these approaches.

CONAN: Let's see if we get that caller in on the conversation now. Let's go to - and there we go - Mark, and Mark is on the line with us from Kokomo, Indiana.

MARK: Kokomo, Indiana, born and raised, and then I moved to San Francisco, California, North Beach/Telegraph Hill and recently moved back to Kokomo, Indiana. So I basically - I just have a comment, being one who's gone from an ultra-liberal environment back to a die-hard conservative, religious environment. What I've learned, sadly, is that the attitude around where I live is that there should not be one dime spent on the research with the goal of finding the cure. This is 100 percent preventable, that (technical difficulties). CONAN: And I think your cellphone, Mark, is betraying you. But, well, Dr. Deeks, that AIDS is a preventable disease.

DEEKS: In San Francisco, there is a tremendous amount of public health interventions and resources that have been poured into trying to prevent the transmission of HIV. It's a highly educated group of people there. There's all these resources. And essentially, the amount of transmission that occurs within our community and within communities around this country have basically not changed. There are fundamental reasons why we think just with the current strategies, it's not going to work in terms of prevention. Now, probably the best way to prevent HIV from being passed around is to get rid of the reservoir, you know, get rid of where the virus is coming from. And we could do that in two ways. We could treat everybody with current therapy. If we treat people with current therapy and they take the drugs, they are less likely to pass the virus on to other people. And this is one of the great things about treatment. It actually works for prevention. But a cure, in theory, would do the same thing.

CONAN: And that treatment, treating everybody, the current price, I think it's about $1,000 a month.

59 DEEKS: Well, that's about $1,000 a month in resource-rich areas. It's much, much less expensive in resource-poor areas.

CONAN: And that's because?

DEEKS: Oh, that's because the drug companies are donating the drugs, things like the Clinton Foundation have come up with resources to basically enable this to happen. I'm not exactly sure how much it costs to treat people in Africa, for example, but it's far less - far, far less than what you just said.

CONAN: Well, Dr. Deeks, thanks very much, and we all wish you the greatest success. Dr. Steven Deeks, professor of medicine at UCSF. He took a break from the International AIDS Conference to come and speak with us here in Studio 3A. And you're listening to TALK OF THE NATION, from NPR News. http://www.npr.org/2012/07/24/157297636/researchers-renewing-focus-on-aids-cure

NPR’s “All Things Considered” & Shorts Blog

HIV Cure Is Closer As Patient's Full Recovery Inspires New Research

By RICHARD KNOX | July 18, 2012

Audio Clip Available

Ask AIDS researchers why they think a cure to the disease is possible and the first response is "the Berlin patient."

That patient is a wiry, 46-year-old American from Seattle named Timothy Ray Brown. He got a bone marrow transplant five years ago when he was living in Berlin.

Brown, who now lives in San Francisco, is something of a rock star in the AIDS community. He has made himself endlessly available to researchers, who regularly bleed and biopsy him to learn as much as possible about his amazing cure.

"I have sort of a guilt feeling about being the only person in the world who's been cured so far," Brown said in an interview with NPR. "I'd like to dispel that guilt feeling by making sure that other people are cured."

The transplant was to cure leukemia unrelated to his HIV infection. The German doctors gave Brown a new immune system from a bone marrow donor who is immune to HIV by virtue of a genetic mutation shared by 1 percent of Caucasians.

61 Brown stopped taking his HIV drugs at the time of the transplant. Five years later, he's still free of HIV drugs — and apparently free of HIV. And he's still the only person to be cured of HIV, doctors say, although everyone acknowledges that bone marrow transplantation is not something that could be used routinely for this purpose.

Dr. Steven Deeks at San Francisco General Hospital is following Timothy Brown closely. He's an organizer of a two-day symposium on curing HIV this week in advance of the International AIDS Conference in Washington, D.C.

Until recently, Deeks says, it was virtually taboo to use "HIV" and "cure" in the same sentence. "It was the C-word," he says. "It was something that we weren't allowed to talk about. We weren't allowed to pursue. I'm not entirely sure why it got to that point."

One big reason is research back in the late 1990s that showed how HIV hides out in certain immune cells. They're called memory cells because they contain a memory of all the infections we encounter in life. They stand ready to attack if a germ reappears.

"HIV has really taken advantage of this very fundamental aspect of the immune system and found a way to essentially hide in these long- lived T-cells," says Robert Siliciano, a professor of medicine at Johns Hopkins University.

Years ago, Siliciano showed that HIV-infected memory cells hang around for 60 or 70 years — basically, a lifetime. But the virus invariably roars to life again as soon as somebody stops taking antiviral drugs.

"People actually began to think this was not going to be a problem that we could solve in the foreseeable future," Siliciano said in an interview.

That's changed. Lately Siliciano and others have discovered that some drugs — such as one that treats alcoholism, another that fights cancer — can wake up the sleeping cells and cause them to spit out hidden AIDS viruses.

The goal is to purge HIV from its secret reservoirs throughout the body. Scientists hoped the memory cells that harbored them would be killed in the process, wiping out the HIV reservoirs. Unfortunately, they were wrong.

"That's been one of the recent discoveries that's been a little bit discouraging," Siliciano says. "Some of the drugs we thought would turn on latent HIV in fact do that, but the cells don't die. Nor are they readily killed by the immune system."

62 Researchers think it might be possible to make a vaccine that would prime the immune system to mop up infected HIV cells after a drug smokes the virus out. Researchers are also on the trail of drugs that are more efficient at purging HIV.

Other scientists are pursuing a different approach — gene therapy. It aims to re-create the Berlin patient's cure, without a risky and expensive bone marrow transplant.

Gregg Cassin is a human guinea pig in an experiment sponsored by Sangamo Biosciences, a California-based company. His experience provides a tantalizing clue that gene therapy against HIV might work.

Cassin thinks he got HIV in the early 1980s. He didn't start antiviral treatment until his immune cell counts plunged to near-zero. He's watched many friends get sick and die from AIDS while he's remained healthy.

Last year Cassin volunteered for the gene therapy experiment. "I wanted to get into the next exciting thing in research," he says, "and completely by accident, I found out I had one of these mutations, the CCR5 mutation."

That's the same mutation that Brown's bone marrow donor had — the genetic quirk that makes him immune to HIV. But Cassin has only one out of two possible mutations, while the Berlin patient's donor has both. So Cassin is only partly protected. But it may explain why he has survived so many years of HIV infection without treatment.

In the gene therapy trial, researchers took out some of Cassin's immune cells and treated them with a chemical called a zinc-finger protease that knocks out both CCR5 genes. Then they grew billions of these engineered cells and injected them back into Cassin.

After a few weeks, according to plan, Cassin stopped taking anti-HIV drugs. He was off therapy for several weeks. But then he panicked.

"This is the part I feel a little bit bad about, a little embarrassed about," Cassin says. "But my viral load shot up, and I got nervous. So I went back onto treatment."

He may have panicked too soon. Two weeks later, Cassin got the results of his latest blood test, which had been done just before he resumed treatment. It showed the amount of HIV in his blood had started to drop sharply, even without antiviral drugs in his system.

"My body was taking care of it," he says.

Scientists will never know whether his viral load, as it's called, would have continued to drop, as Brown's did after a similar initial spike. That will take many more patients who have more definite and lasting benefits.

The same goes for other would-be cures. Most researchers think in the end the answer will be a combination of approaches.

63 Meanwhile, Brown is still teaching scientists lessons. Recent research suggests a few of his cells may still contain traces of HIV, or rather, HIV genes. But if that's true, researcher Deeks says it doesn't seem to matter.

"The consensus on what actually happened," Deeks says, "is that he's cured clinically. Whether there's any virus left, we're not sure. But we can't detect anything that can replicate, and his immune system is no longer really responding to the virus. Which to us suggests that the virus must be almost gone."

If so, "almost gone" may be good enough — and that's an important insight. As they say, more research is needed.

I asked Brown if he's going to put up with being poked and prodded for years to come. "I think so," he says. "Until there's a cure, I'm going to keep working for it. And well, hopefully, one day I won't have to do it any more" because he'll be just one of many cured of HIV.

"That would be nice," he says. http://www.npr.org/blogs/health/2012/07/18/156988650/hiv-cure-is-closer-as-patients-full- recovery-inspires-new-research?ps=sh_stcathdl

France Info Début de la 19e conférence mondiale sur le Sida sous le signe de l'espoir

LE DIMANCHE 22 JUILLET 2012 À 15:12

Quelque 25.000 personnes sont réunies à partir de ce dimanche à Washington pour la 19e conférence mondiale sur le Sida. Les participants entendent se mobiliser encore pour mettre fin à la pandémie. Mais cette fois-ci, les chercheurs estiment qu'éradiquer la maladie pourrait devenir possible avec les traitements existants.

C'est une première depuis 22 ans : la conférence mondiale sur le Sida fait son retour aux Etats-Unis, où, depuis 1990, l'entrée du pays était interdite aux personnes séropositives ; mesure supprimée en 2009 par Barack Obama. Jusqu'à vendredi, 25.000 personnes participent à la 19e édition de cette conférence qui réunit des experts, mais aussi des personnalités influentes : Hilary et Bill Clinton, Bill Gates et Elton John sont notamment attendus lors de ce congrès.

Une conférence placée cette année sous le signe de l'espoir, selon les chercheurs : ils estiment que les médicaments développés depuis vingt ans permettent d'envisager la fin de l'épidémie. De récents essais cliniques montrent que les antirétroviraux permettent de réduire le risque de contamination des personnes séronégatives qui ont des rapports sexuels à risque. Il ne faut pas, toutefois, que ces annonces diminuent la vigilance, notamment chez les jeunes : "Ne limitons pas cet essai à la fin du Sida. C'est trop risqué", rappelle Bruno-Pascal Chevalier, militant depuis 25 pour la prévention du Sida.

Reste à étendre l'accès à ces traitements : selon des chiffres de l'Onusida, plus de 8 millions de personnes contaminées par le virus prenaient des antirétroviraux en 2011. Mais ce chiffre ne représente que 54% des 15 millions d'infectés qui en ont besoin. A l'heure actuelle, en tout, environ 35 millions de personnes dans le monde sot infectées par le VIH.

http://www.franceinfo.fr/monde/debut-de-la-19e-conference-mondiale-sur-le-sida-sous-le- signe-de-l-espoir-684337-2012-07-22

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Los Angeles Times (USA)

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Washington Post (USA)

Economist (UK)

Looking into the future

Now that the means exist to bring AIDS under control, attention is turning towards a cure

Jul 28th 2012 | WASHINGTON, DC | from the print edition

“CAN AIDS be cured?” That was the question being whispered in the back rooms and satellite meetings of the 19th International AIDS Conference, held in Washington, DC, this week. The conference’s formal business was to keep up the momentum behind the most successful public- health campaign of the past 30 years: the taming, at the cost of a few pills a day, of an infection that was once an inevitable killer. It still kills. About 1.7m people succumbed last year. But that figure is down from 2.3m in 2005 (see chart 1), and is expected to continue falling. Now, therefore, some people are starting to look beyond the antiretroviral (ARV) drugs which have brought this success. They are asking if something else could do even better.

The drugs work, and are getting cheaper by the year: a report released during the conference by the Clinton Foundation, an American global-health charity, put the annual cost of treatment at $200; it used to be $10,000. But once on them, you are on them for life. Stop, and the virus crawls out of

70 cellular hidey-holes that ARVs cannot reach and rapidly reinfects you. This has implications both for patients, whose lives are constrained by the need for constant medication, and taxpayers, who bear most of the cost of this indefinite treatment.

Many of those taxpayers do not live in the rich world but in the worst-afflicted countries. A new estimate by UNAIDS, the United Nations agency charged with combating the disease, suggests that more than half of the cost of treating and preventing AIDS is now borne by these countries, rather than paid for by international agencies (see chart 2). As many of these countries have high economic growth rates, that is only right and proper. But it does mean that they, too, have a strong interest in a cure. And researchers would like to provide them with one.

The road to Berlin A race is therefore on to work out how to flush the virus from its hiding places and get rid of it completely. Several clues suggest a cure may be possible. But no one knows which route will lead to it.

One of those routes passes through Timothy Brown. Mr Brown, pictured above, is known as the Berlin patient. He was living in that city in 2007 when he underwent radical treatment for leukaemia. This required the destruction of his immune system—the source of the cancer—and its replacement using stem cells transplanted from the bone marrow of a donor, which allowed him to grow a new (but alien) immune system.

Mr Brown did not just have leukaemia. He was also infected with HIV. So his doctor, with his permission, tried an experiment. The doctor searched for and found a donor who had a rare genetic mutation which confers immunity to HIV infection by disabling a protein on cell surfaces to which the virus attaches itself in order to gain entry to a cell.

After the transplant, the virus seemed to disappear from Mr Brown’s body. Traces of viral genes were found recently, but these may have been contamination, and in any case they did not amount to entire, working viruses. There is no disputing, however, that Mr Brown no longer needs drugs to stay healthy, and has not needed them for five years.

No one is suggesting immune-system transplants as a treatment for AIDS. They are far too dangerous and costly. The intriguing point about Mr Brown’s

71 procedure is that it would have been expected to destroy directly only one of the hiding places of the virus: immune-system cells squirrelled away in a quiescent state as the system’s memory. (These allow it to recognise and respond to infections experienced in the past.) Other reservoirs, particularly certain brain cells, would not have been affected directly—and in Mr Brown’s case checking his brain to find out what is going on would be grossly unethical.

Clearly, it is dangerous to draw conclusions from a single example. But if quiescent memory cells are the main source of viral rebound, that would simplify the task of finding a cure. And many groups of researchers are trying to do just that, by waking up the memory cells so that ARVs can get at the virus within them.

Once such group, led by David Margolis of the University of North Carolina, uses an established anticancer drug called vorinostat as the wake-up call. This drug activates quiescent cells by tweaking the proteins that wrap their DNA. Dr Margolis’s latest results, announced to the conference and published simultaneously in Nature, suggest vorinostat does indeed awaken dormant memory cells, though the experiment did not ask whether that can in turn lead to the elimination of the virus.

Dr Margolis’s approach looks interesting. But it is not the only one on offer. A second, the so-called Visconti trial undertaken by France’s National Agency for Research on AIDS, studied people who had been put on ARVs immediately after they became infected. Some of these, the study found, become what are known as elite controllers.

An elite controller is an individual who is infected, but whose immune system seems able to suppress viral replication by itself. Elite controllers thus never develop the symptoms of AIDS. Natural cases of elite control are rare, but the Visconti trial (the name is a contraction of “Virological and immunological studies in controllers after treatment interruption”) seems to have found a way to create them artificially. Its dozen participants have lived without ARVs for an average of six years, having previously used them for an average of three. And the latest results from the study suggest the pattern of infection of their immune system closely resembles that seen in natural elite controllers.

Reasons to be cheerful Amid all this scientific interest, however, the conference did not neglect the more immediate question of how the tools now available can be deployed. The watchword, borrowed from the jargon of drug delivery, is combination prevention.

The crucial trick with ARVs is to use several different treatments simultaneously, an approach known as combination therapy. Attacked from many directions, the virus cannot escape. A similar method is now being applied to preventing transmission. Three techniques, beyond the traditional (and successful) one of exhorting couples to use condoms, have now been demonstrated to work. Researchers are busy crunching data that will allow them to suggest what emphasis should be placed on which techniques in different parts of the world.

One technique, treatment-as-prevention, relies on the fact that ARVs themselves suppress transmission. A cross-continental study published last year showed that, when given to infected individuals whose sexual partners are uninfected, ARVs reduce by 96% the rate of transmission of the virus to the uninfected partner. Another study, published this July, showed that giving ARVs to the uninfected partner reduces their chances of becoming infected by 75%. These studies prove

72 what might reasonably be suspected: that the smaller the amount of virus in someone’s body, the harder it is to pass it on; and that organising a hostile reception makes it hard for the virus to take hold.

Treatment-as-prevention raises questions about how ARVs should be used in the future. At the moment, 8m people in poor and middle-income countries take them and the aim is to increase that to 15m. At that point, all those sick enough to warrant being treated would be under treatment. But a further 19m are infected. Prevailing opinion is that they need not be treated because their disease has not progressed to a point where it threatens their health. Yet if ARVs were used as preventatives, these people, too, would need to take them. Many would, to avoid infecting their lovers. But some might not want to. And for those who did the ARVs would have to be paid for. So the drug bill would go up.

The second approach uses ARVs to stop one very specific form of transmission: that between an infected mother and her child at birth, or during suckling. Using the latest drugs this is more than 95% effective, and it is easy to do because most pregnant women go to a doctor or a clinic before they give birth and can thus (with their permission) be tested for HIV.

The third technique is circumcision. Men’s foreskins are rich in immune-system cells, which are there to prevent the entry via the penis of infectious agents. Unfortunately, some of these cells are particularly susceptible to HIV infection. Removing the foreskin thus has a huge effect. It reduces, by about two-thirds, the risk of a man becoming infected. And follow-up studies suggest that with time this figure may rise to three-quarters.

In Africa, circumcision has, as it were, gone viral. The definitive studies showing it worked were published in 2006. After a slow start, hundreds of thousands of men have now had the snip. In 13 countries of eastern and southern Africa that are regarded by the World Health Organisation as being priority areas for the procedure, over half a million men were circumcised explicitly for AIDS protection between 2008 and 2010. The clinics can barely keep up, and several devices designed to simplify the process are now being tested.

The upshot of all this activity is a marked reduction in the rate of new infections, though sceptics point out that the fall began before ARV use and circumcision became widespread, and that the role of behavioural changes (including a greater willingness to use condoms) should thus not be underestimated.

Regardless of the cause, the graphs are all pointing in the right directions: ARV use is up; deaths and new infections are down. Soon, more people will be put on ARVs each year than die of the disease. That will be cause for celebration. AIDS is not yet beaten, and may be a long time in the beating. But if the will is there, then the means exist to do it. http://www.economist.com/node/21559594

Independent (UK)

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USA Today

http://www.usatoday.com/news/health/story/2012-07-19/aids-cure/56341144/1

77 Wall Street Journal

78 ORIGINAL ONLINE

ABC News “Medical Unit”

Two More Patients HIV-Free After Bone Marrow Transplants

Jul 26, 2012 3:06pm By LIZA McCLELLAN, M.D.

Researchers at Brigham and Women’s Hospital in Boston have discovered that, following bone marrow transplants, two men no longer have detectable HIV in their blood cells.

The finding is significant because it suggests that by giving these patients transplants while they were on anti-retroviral therapy, they may have been cured of the AIDS-causing virus.

“We expected HIV to vanish from the patients’ plasma, but it is surprising that we can’t find any traces of HIV in their cells,” said Dr. Timothy Henrich, one of the researchers studying the two men. “It suggests that under the cover of anti-retroviral therapy, the cells that repopulated the patient’s immune system appear to be protected from becoming re-infected with HIV.”

The findings were presented Thursday at the AIDS 2012 conference in Washington, D.C. The story shares similarities with that of Timothy Ray Brown, also known as “the Berlin patient,” but there are important differences. While the cells used in Brown’s transplant procedure were specifically chosen from a donor who had a genetic mutation that resisted HIV, these patients received transplants with normal cells. Also, the two patients whose cases were presented at the meeting are still taking anti-retroviral medications normally used to treat HIV-positive patients, while Brown is no longer taking these medications.

Further study will need to be done to prove that the two patients are truly cured.

“Studies over time including biopsies of lymphatic tissue would be required,” said Dr. Michael Saag, an infectious disease expert from University of Alabama at Birmingham. He said only time will tell if these patients remain HIV-free.

While it appears from these cases, as well as that of the Berlin patient, that altering a patient’s immune system may lead to a “cure” for HIV, bone marrow transplants are currently too costly and dangerous for all HIV patients to be able to undergo them.

Separately, scientists are trying to use gene therapy to alter patients’ immune systems to free them of HIV. Most of the research in this field is very preliminary, but scientists at the Fred Hutchinson Cancer Research Center are trying to perform stem cell transplants with cells that have been genetically modified to be resistant to HIV, much like the cells that the Berlin patient received. “We have not yet transplanted any patient as part of our study,” said Dr. Hans-Peter Kiem of the Clinical Research Division at Fred Hutchinson Cancer Research Center and an attending transplant physician at Seattle Cancer Care Alliance. But Kiem and his research team have recently been awarded a research grant to further investigate stem cell transplantation as treatment as a means to find a cure for HIV. http://abcnews.go.com/blogs/health/2012/07/26/two-more-patients-hiv-free-after-bone- marrow-transplants/

Boston Globe (USA)

Researchers report hopeful HIV treatment

Disease quashed in two patients at Boston clinic

By Helen Shen JULY 26, 2012| GLOBE CORRESPONDENT

WASHINGTON — In a finding that could offer vital clues to scientists working to cure AIDS, Boston researchers reported Thursday that the virus was quashed beyond detection in two HIV-infected patients who underwent bone marrow transplants while taking powerful drug cocktails. Scientists from Brigham and Women’s Hospital and Harvard, who presented their research at the 2012 International AIDS Conference, were careful to say the patients had not been cured of the disease.

Still, some HIV specialists not involved in the research said it yielded important insights into how a cure for AIDS might eventually be developed.

The Boston patients, who came to the hospital seeking treatment for cancer, share similarities with a man known as the “Berlin patient.” German doctors reported in 2009 that an American, Timothy Brown, was given a bone marrow transplant for leukemia and appeared to have been cured of HIV. Although multiple laboratories continue to analyze Brown’s samples, most scientists believe that Brown remains the only person to have been cured of HIV.

Dr. David Margolis, an HIV researcher at the University of North Carolina at Chapel Hill, said the Boston cases could drive new interest in research for a cure, much like Brown’s case did. “You want to see it happen more than once and at least begin to understand how it happened,” Margolis said. The Boston patients both suffered from Hodgkin’s lymphoma, a cancer of the blood. One also had other blood cancers. After chemotherapy and other treatments failed, doctors at the Dana- Farber/Brigham and Women’s Cancer Center performed bone marrow transplants to replace the patients’ cancerous blood cells with healthy donor cells.

Unlike Brown and many other HIV-positive cancer patients, the two men received only mild chemotherapy and remained healthy enough to continue their HIV medications during cancer treatments.

Dr. Daniel Kuritzkes and Dr. Timothy Henrich of the Brigham, who studied the patients, said they believe antiviral drugs provided HIV protection that allowed the donated bone marrow cells to rid the body of cancer while not becoming infected with the AIDS virus.

81 The patients’ blood showed no trace of HIV — not even in the smallest genetic building blocks — within eight to nine months of their transplants. “They went from this easily measured amount in their blood to no measurable amount in their cells,” Kuritzkes said. “We frankly didn’t expect that.” Not all scientists at the conference were impressed. “The real news would be if they could stop the drugs and not have the virus come back,” said Dr. Jay Levy, an HIV researcher at UC San Francisco. Brown has remained free of HIV without the use of medications.

Levy also noted that antiretroviral therapies are so successful at controlling HIV in many people that the virus all but disappears.

Many researchers also pointed out that the virus could still be present in the patients, in the lymph nodes or bowels, where it is known to hide.

Kuritzkes and Henrich said more extensive tests will be crucial in determining whether the virus has truly been eradicated. At the same time, they are discussing with the patients, their oncologists, and hospital regulatory committees about whether to stop HIV drug treatments. “There’s a chance that the virus could come back, so we have to make sure that this is done safely and ethically,” Henrich said.

Bone marrow transplantation can cost hundreds of thousands of dollars, and it proves fatal for 15 percent of recipients. Typically, cancer patients receive bone marrow transplants after other options fail. So, the treatment could not be broadly applied to HIV patients, especially those who are managing the infection well with medication.

For scientists, even if there are not immediate applications of the research for patients, it points to intriguing avenues.

Brown’s doctors selected a bone marrow donor who carried two copies of a gene mutation, called CCR5-delta32. The rare double mutation is thought to provide resistance to HIV, and has been of intense interest to researchers pursuing an HIV cure. Previously, researchers had not observed similar results with ordinary donor cells, such as those given to the Boston patients.

In these men, circulating donor cells lack the protective gene mutation evident in the bone marrow given to Brown. The Boston results suggest that infusing ordinary cells under the cover of antiretroviral therapy could be one component of a future HIV cure.

“We’re not there in terms of a broadly applicable approach, but every step really gets people excited,” Deeks said. “It’s not easy, but it’s not as hard as we thought.” http://bostonglobe.com/lifestyle/health-wellness/2012/07/26/hiv-patients-boston-show-signs- virus-after-bone-marrow-transplant/aYNVWR8HFcUIKxvUt3n95H/story.html

Boston Globe’s “White Coat Notes”

2 HIV patients in Boston show no signs of virus after bone marrow transplant

By Helen Shen, Globe Correspondent 07/26/2012 2:31 PM

WASHINGTON -- Two HIV-positive patients in Boston who underwent bone marrow transplants for cancer were later found to have undetectable blood levels of HIV, according to research presented at the 2012 International AIDS Conference Thursday.

Scientists say it is too early to call the patients “cured” of the virus, which causes AIDS, because the men are still taking drugs to treat HIV. But the results offer intriguing insights into how an eventual HIV cure might be developed.

“These researchers have done some elegant work,” said Dr. Steven Deeks, an HIV researcher at the University of California, San Francisco, “and found results that I think are going to be very provocative.”

The patients share some similarities with the “Berlin patient” -- Timothy Brown, an American who was given a bone marrow transplant for leukemia and reported by his German doctors to have been cured of HIV in 2009.

Both of the Boston patients suffered from Hodgkin’s lymphoma, a cancer of the blood. One also had other blood cancers. After chemotherapy and other treatments failed, doctors at the Dana- Farber/Brigham and Women’s Cancer Center performed bone marrow transplants to replace the patients’ cancerous blood cells with healthy donor cells.

Dr. Daniel Kuritzkes and Dr. Timothy Henrich of Brigham and Women’s, who studied the patients, found that the patients’ blood showed no traces of HIV particles and viral DNA within eight to nine months of their transplants.

Unlike most HIV-positive cancer patients, the two men remained healthy enough to continue their HIV medications during cancer treatments. Kuritzkes and Henrich believe the drugs were the key to the patients’ success.

83 “We’ve shown that you can transplant cells from an uninfected donor that are susceptible to HIV, and protect them from becoming HIV-infected,” said Henrich, “so long as the recipient is maintained on antiretroviral therapy.”

Bone marrow transplantation can cost hundreds of thousands of dollars, and it proves fatal for 15 percent of recipients. Typically, cancer patients receive bone marrow transplants after other options prove ineffective. So, the treatment could not be broadly applied to HIV patients.

“We’re not going to be doing bone marrow transplants on healthy HIV-infected patients who are doing well on antiretroviral therapy,” said Kuritzkes.

Brown also received a bone marrow transplant to treat leukemia. However, doctors used a donor who had a rare genetic mutation that provides resistance against HIV. So far, no one has observed similar results using ordinary donor cells such as those given the Boston patients. Many scientists are waiting to see whether the Boston patients can now remain HIV-free without the help of antiretroviral drugs, like Brown.

“That event was part of what has created a more serious interest in attempts to eradicate HIV,” Dr. David Margolis, an HIV researcher at the University of North Carolina at Chapel Hill, said of Brown’s case. “You want to see it happen more than once and at least begin to understand how it happened.” Kuritzkes and Henrich said they are in discussons with the patients, their oncologists, and hospital regulatory committees to decide whether to stop HIV treatments for the patients. http://www.boston.com/whitecoatnotes/2012/07/26/hiv-patients-boston-show-signs-virus- after-bone-marrow-transplant/OsWbGbCtDq70CoWOZ0A2tI/story.html

CBS News (USA)

Bone marrow transplant eliminates HIV traces from two patients' DNA: Call it a cure?

July 27, 2012 3:09 PM By Ryan Jaslow

(CBS News) Two men who've had HIV for years may now be free of the disease following bone marrow transplants, researchers at Brigham and Women's Hospital in Boston announced Thursday. The new research has some attendees at the XIX International AIDS Conference in Washington, D.C. hopeful for a cure.

Timothy Ray Brown, man thought to be first "cured" of AIDS, says he's still cured Man "cured" of AIDS: Timothy Ray Brown

Both patients were being treated for cases of cancer. One of the patients underwent a bone marrow transplant two years ago at the Dana-Farber/Brigham and Women's Cancer Center in Boston, the other had the procedure done four years ago at the same hospital.NBCNews.com reports that one of the patients is in his 50s and has been infected since the early 1980s towards the beginning of the AIDS epidemic and the other man, in his 20s, was infected at birth.

Both stayed on their antiretroviral medication regimens, the standard treatment of HIV, following the transplants.

The researchers discovered that overtime as the patients' cells were replaced by cells from the donor, evidence of HIV in the patients' blood tests disappeared. The researchers also said both patients have no signs of HIV in their DNA or RNA and levels of their disease-fighting antibodies have also decreased. The researchers think the medications helped allow these cells to be replaced. "This gives us some important information," one of the researchers Dr. Daniel Kuritzkes, an infectious disease specialist at the hospital and Harvard Medical school said in a press release. "It suggests that under the cover of antiretroviral therapy, the cells that repopulated the patient's immune system appear to be protected from becoming re-infected with HIV."

The researchers themselves won't call it a cure yet, saying they still need to check more tissues for traces of the disease. But they were surprised to see no signs of HIV beyond what's seen in a blood test.

"We expected HIV to vanish from the patients' plasma, but it is surprising that we can't find any traces of HIV in their cells," said co-resarcher Dr. Timothy Henrich, also of BWH and Harvard. "The next step is to determine if there are any traces of HIV in their tissue."

The researchers' announcement comes days after Timothy Ray Brown, the man known as the "Berlin Patient," held a press conference in Washington, D.C., to say he's still cured of AIDS five years after undergoing a bone marrow blood transplant.

85 However, the researchers noted differences in their two patients' treatment compared to that of Brown. In Brown's case, his donor was specifically chosen because he possessed a genetic mutation that's found in one person of Caucasian people that makes them resistant to developing HIV. But the donors for the two Boston patient were selected at random. Additionally, Brown had stopped taking his antiretroviral medications following his transplant, while the Boston patients have stayed on the drugs.

Traces of HIV have been found in Brown's tissues, causing some to say the virus had returned, but he denied that at his press conference, saying those are merely dead remnants of the virus still in his body.

"We can't say we've replicated the Berlin patient's cure at this point because our patients remain on antiretroviral therapy," Kuritzkes told NPR. He did add to the station that it's "entirely possible" the two patients will remain disease-free.

Dr. Steven Deeks, an HIV researcher at the University of California, San Francisco, told The Washington Post, "Today might be considered a day when the research agenda moves from basic science and the lab into the clinic," adding that "it is an absolutely critical advancement."

Not all experts were impressed. Dr. Jay Levy, another HIV researcher at UC San Francisco, toldThe Boston Globe, "The real news would be if they could stop the drugs and not have the virus come back." http://www.cbsnews.com/8301-504763_162-57481578-10391704/bone-marrow-transplant- eliminates-hiv-traces-from-two-patients-dna-call-it-a-cure/

Daily Mail (UK)

Two men remain HIV-free two years after bone marrow transplants

By CLAIRE BATES PUBLISHED: 06:39 EST, 27 July 2012 | UPDATED: 09:35 EST, 27 July 2012

Two men with longstanding HIV infections no longer have detectable HIV in their blood cells years after having bone marrow transplants.

The virus was easily detected in both men in their lymphocytes - blood cells that work to defend the immune system against attack - before the operation. However, it became undetectable eight months after the surgery.

The patients, who were treated at Brigham and Women's Hospital (BWH), have remained on antiretroviral therapy since the transplant. These drugs work to suppress the virus.

'This gives us some important information,' said Dr Daniel Kuritzkes.

'It suggests that under the cover of anti-retroviral therapy, the cells that repopulated the patient's immune system appear to be protected from becoming re-infected with HIV.'

One patient's bone marrow transplant was two years ago while the other was four years ago.

Over time, as the patients' cells were replaced by donor cells, traces of HIV were lost. The level of HIV antibody, a measure of exposure to HIV, also declined in both men.

'We expected HIV to vanish from the patients' plasma, but it is surprising that we can't find any traces of HIV in their cells,' said Dr Timothy Henrich.

'The next step is to determine if there are any traces of HIV in their tissue.'

Researchers point out that there are two key differences between the Brigham patients and the 'Berlin patient,' Timothy Brown, who was functionally cured of HIV after a stem cell transplant.

87 In the Berlin patient's case, his donor was specifically chosen because the donor had a genetic mutation that resisted HIV. The Brigham patients' bone marrow transplants were done without any thought to selecting an HIV-resistant donor.

Second, the Berlin patient ceased anti-retroviral therapy after his transplant, while the Brigham patients have remained on anti-retroviral therapy.

Their cases will be presented at the International AIDS Conference at the BWH in Boston.

http://www.dailymail.co.uk/health/article-2179810/Two-men-HIV-free-years-bone-marrow- transplants.html#ixzz21qqojNzK

Daily Mail (UK)

Cure for AIDS a step closer as common cancer drug is found to 'purge' dormant HIV from body

By ROB WAUGH PUBLISHED: 06:08 EST, 26 July 2012 | UPDATED: 06:08 EST, 26 July 2012

A cure for AIDS has got a step closer after scientists found that a common cancer drug can purge the disease as it lies dormant in the body.

Current treatments are effective at reducing levels of the disease in the bloodstream - but a drug that can 'knock out' the disease when it lies dormant is thought to be key to a cure. Tests on eight HIV-positive men found that the drug was highly effective in 'unmasking' the hidden reservoirs in the body - which the researchers say is a vital step towards eradicating HIV from the body.

‘This work provides compelling evidence for a new strategy to directly attack and eradicate latent HIV infection,’ said David Margolis at the University of North Carolina at Chapel Hill. ‘Long-term, widespread use of antiretrovirals has personal and public health consequences, including side effects, financial costs, and community resistance,’ said Margolis, who led the study.

‘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.’

The existence of persistent reservoirs of dormant HIV in the immune system that are not attacked by anti-AIDS drugs is believed to be a major reason why infection reemerges once patients stop taking their medication.

The disruption and clearance of these reservoirs is critical to finding a cure for AIDS.

Researchers from the University of North Carolina at Chapel Hill have published pioneering research showing that a drug used to treat certain types of lymphoma was able to dislodge hidden virus in patients receiving treatment for HIV.

Researchers at UNC, working in collaboration with scientists from the Harvard School of Public Health, National Cancer Institute, Merck, and the University of California at San Diego, undertook a series of experiments designed to evaluate the potential of the drug vorinostat, a deacetylase inhibitor that is used to treat some types of lymphoma, to activate and disrupt the dormant virus.

89 Initially, laboratory experiments measuring active HIV levels in CD4+ T cells, which are specialized white blood cells that the virus uses to replicate, showed that vorinostat unmasked the hidden virus in these cells.

Subsequently, vorinostat was administered to eight HIV-infected men who were medically stable on antiretroviral therapy and the levels of active HIV virus were measured and compared to the levels prior to administration.

Those patients receiving vorinostat showed an average 4.5-fold increase in the levels of HIV RNA in CD4+ T cells, evidence that the virus was being unmasked.

This is the first published study to show the potential for deacetylase inhibitors to attack latency within dormant virus pools in a translational clinical study.

Targeting latency is the first step on a path that may lead to a cure.

http://www.dailymail.co.uk/sciencetech/article-2179262/Cure-AIDS-step-closer-common-cancer-drug-purge- dormant-HIV-body.html#ixzz21ltgDQD9

El País (Spain)

Dos investigaciones abren la vía hacia la cura funcional del sida

CAROLINA GARCÍA Washington 27 JUL 2012 - 09:07 CET

Un pequeño grupo de 14 pacientes franceses no ha sufrido un rebrote del VIH tras serle suspendido el tratamiento antirretroviral que se les empezó a suministrar muy poco después de contraer la infección, según concluye un estudio elaborado en el país galo y presentado este jueves durante la quinta jornada de la Conferencia Internacional sobre el Sida en Washington. Este resultado reabre la esperanza de que una cura funcional del VIH –conseguir niveles del virus extremadamente bajos en sangre que impidan al cuerpo desarrollar sida y permitan al paciente dejar la medicación– es posible.

La investigación, denominada Visconti cohort, consistió en intentar controlar la infección lo antes posible. Esta situación no es muy común ya que, por ejemplo, en Estados Unidos una de cada cinco personas desconoce ser portadora del VIH y recibe el diagnóstico en estadios tardíos, según datos del Centro de Prevención de Enfermedades. Los sujetos estuvieron bajo tratamiento hasta tres años. “Normalmente, los niveles de virus en el cuerpo habrían aumentado con la supresión del tratamiento y la infección habría derivado en la enfermedad del sida. Pero tras seis años sin medicación, los niveles de virus en sangre son extremadamente bajos. Nuestras conclusiones sugieren que el tratamiento debe empezar lo antes posible, lo más próximo al inicio de la infección”, explicó en rueda de prensa Charline Bacchus, jefa del equipo del estudio de la Agencia Nacional Francesa de Investigadores del Sida.

“Realmente creemos que este grupo es una esperanza real para la investigación a partir de ahora”, añadió Asier Saez Ciron, del Instituto Pasteur en este país. Existe un centenar de personas en el mundo que, a pesar de estar infectadas, no desarrollan la enfermedad –los denominados controladores de VIH–, y “lo bueno de este estudio es que hemos conseguido un efecto similar con la aplicación de fármacos. Puede ser una esperanza más para la cura funcional del virus”, continuó Saez Ciron. Los autores reconocen que esta investigación es la primera de muchas: “Debemos seguir estudiando en esta dirección y corroborar que estos esperanzadores resultados se siguen produciendo”, finalizó Saez.

Otro estudio presentado este jueves apunta que, aparte del conocido como el paciente de Berlín, Timothy Brown –la única persona documentada que se ha curado de la enfermedad–, existen dos casos más de curas funcionales: dos hombres con VIH y linfoma –un cáncer que afecta al sistema linfático–. A ambos pacientes se les realizó un trasplante de médula para tratar su cáncer y fueron tratados con bajos niveles de quimioterapia durante el proceso, lo que permitió mantener la terapia antirretroviral simultáneamente. A pesar de que se detectaron células infectadas con el

91 virus en este periodo, con el paso del tiempo las células donadas reemplazaron a las infectadas. Aparentemente, los dos pacientes se encuentran libres de VIH: uno lo consiguió a los dos años de la operación y el otro, tras tres años y medio.

Durante los dos últimos años, los científicos han estado investigando para llegar a esta conferencia con resultados tangibles. Françoisse Sinoussi, premio Nobel de medicina por identificar el VIH en la década de los ochenta, es la líder de esta iniciativa. Sinoussi ha recalcado durante esta semana que “a pesar de los resultados obtenidos, los esfuerzos deben seguir centrándose en la búsqueda de una vacuna”.

Prevención Los expertos asistentes a la Conferencia Internacional de Sida llamaron también la atención este jueves sobre la necesidad de potenciar los mecanismos de prevención entre los grupos sociales más discriminados, los que cuentan con menos recursos y sufren los mayores porcentajes de prevalencia de esta enfermedad. Se insistió además en que todavía hay que trabajar mucho para poner fin a una pandemia que ha matado ya a 30 millones de personas en todo el mundo. “Hombres que tienen sexo con hombres existen en todas partes. Si decidimos no admitir esta realidad, no podremos terminar con la epidemia y no podremos afrontar de verdad la infección del VIH”, dijo Paul Semugona, doctor de Uganda, durante la sesión plenaria de la jornada. Este médico recalcó que todavía existen naciones en las que no se reconoce la existencia de la homosexualidad, “por lo que no existen estadísticas reales sobre el número total de gais. Pero lo vuelvo a decir, por mucho que lo quieran esconder, existen”, reiteró.

“Yo soy gay, vivo en Uganda y en mi país no me habían informando de que esta enfermedad se podía transmitir al tener relaciones sexuales con otro hombre. Si no te has acostado con una mujer, no estarás infectado, eso me decían”, continuó Semugona, “porque eran las mujeres las que nos infectaban”. Este doctor desconocía cómo debía protegerse, era un ignorante: “Tuve que recurrir a Internet y aprender yo mismo a conocer lo que es el sida. Y como yo, muchos otros han tenido que hacer lo mismo en muchos otros países”. “Hay que hacer visibles a los invisibles para luchar y ganar a la epidemia del sida”, añadió.

Pero el precio del activismo es a veces “la criminalización”. “Han apresado e incriminado a muchos. Lo están haciendo ahora y por desgracia lo harán en el futuro”, subrayó durante la conferencia Cheryl Overs, profesora de la Universidad Monash en Australia, en clara referencia a las grandes voces ausentes en la conferencia de Washington: la de muchas personas que se dedican a la prostitución o drogadictos a los que la ley estadounidense no ha permitido entrar en el país. Por eso, tras mostrar un vídeo en el que se narraban historias de estos dos colectivos, la profesora australiana proclamó: “No se crean todo lo que escuchen esta semana. Hay muchas historias que no se cuentan”. “Cambiemos las leyes, que la prostitución sea legal y que a los drogadictos se les trate como a personas enfermas, y no como a animales”, insitió Overs.

“Llevamos seis días escuchando que con los métodos de prevención con que contamos ahora se puede conseguir una generación libre de sida. ¿Pero qué ocurre con la discriminación, la pobreza como factor de riesgo o el rechazo de la propia familia? En una conferencia bianual que habla del fin de la epidemia, es necesario que los trabajadores sexuales y los drogadictos no se queden fuera, porque son parte fundamental de la solución. Se necesita acción y no mera propaganda”, concluyó la profesora. http://sociedad.elpais.com/sociedad/2012/07/27/actualidad/1343372864_270643.html

El País (Spain)

Los investigadores del sida buscan respuestas en las curaciones "milagrosas"

CAROLINA GARCÍA Washington 25 JUL 2012 - 10:19 CET

En el tercer día de la Conferencia Internacional del Sida 2012 en Washington, la protagonista fue la ciencia y los caminos hacia la curación del VIH. Un día en el que la recesión económica, la ciencia y los desafíos confluyeron. Javier Martínez-Picado, investigador del Instituto IrsiCaixa en Barcelona y experto en la investigación del origen del VIH, fue el encargado de abrir la jornada en la sesión plenaria. “La investigación actual para encontrar una cura implica un gran número de retos. Uno de los éxitos mayores de la ciencia reciente es haber mejorado los antirretrovirales, pero a pesar de ello estos fármacos no curan la infección. Todavía, por cada persona que inicia la terapia antirretroviral, dos personas se infectan por el virus”.

La mortalidad por VIH sigue decreciendo y la supervivencia es mayor gracias a los tratamientos, “aunque también es verdad que aumentan las enfermedades relacionadas con el uso de estas medicaciones, como el cáncer”, señaló Martínez-Picado. Y admitió que los efectos secundarios de los antirretrovirales —como los fallos renales, las afecciones en el cerebro o el hígado— pueden provocar rebrotes del virus en los pacientes. “Debemos llegar a fármacos que detengan la formación de nuevas células que pudieran derivar en la enfermedad del sida”, explicó. Las estrategias para conseguir la cura del VIH son dos, según este investigador: “La erradicación de las células infecciosas y la remisión de las mismas de forma funcional, de largo recorrido en el tiempo”.

93 Durante las conferencias de la jornada, los investigadores anunciaron que están focalizando su atención en las historias casi milagrosas de un pequeño grupo de personas en el mundo que han conseguido superar o controlar definitivamente el VIH o el sida. Uno de ellos es el estadounidense Timothy Ray Brown, conocido como el paciente de Berlín, el único afectado que ha logrado curarse del sida —era seropositivo y padecía leucemia—. Brown anunció en el hotel Westin City Center de Washington la creación de una Fundación con su nombre cuyo objetivo es encontrar una solución definitiva. “No quiero hacer de mi curación mi peor enemigo”, dijo Brown en relación con el tratamiento que le ha salvado la vida.

Martínez-Picado explicó que Brown necesitó, además del tratamiento antirretroviral, de una serie de intervenciones médicas para superar la enfermedad; entre ellas la irradiación de todo su cuerpo y dos trasplantes de médula ósea de un donante compatible que tenía una mutación del gen CCR5, que actúa como puerta de entrada para que el VIH entre en las células. Parece que las personas que carecen de este gen son inmunes al VIH. “Y la realidad es que han pasado cinco años desde los trasplantes y el paciente no ha sufrido un rebrote viral. Lo que le convierte en el primero en curarse del sida”, puntualiza Martínez-Picado. Los expertos señalan que, a pesar del éxito, el tratamiento seguido por Brown implica un alto riesgo de muerte. “Es tan complicado que no se podría realizar a gran escala”, concluye el investigador.

Los científicos están también muy interesados en las personas que, a pesar de estar infectadas por el VIH, no padecen sida. Son los llamados controladores, apenas un centenar en todo el mundo. Otro colectivo de análisis es el de aquellos capaces de paliar el rebrote del virus, que suponen entre el 5% y el 15% de los infectados. “Podemos, entonces, hablar de soluciones basadas en la ciencia de una forma que no era posible hace unos años”, aseguró Diane Havlir, profesora de medicina en la Universidad de California.

España también fue protagonista durante la jornada de ayer. Tras el anuncio de que el Ministerio de Exteriores va a restablecer su ayuda al Fondo Global de la Lucha contra el Sida, la Tuberculosis y la Malaria con 10 millones de euros, después de suspenderse la contribución en 2011 por sospechas de corrupción, las reacciones de asociaciones como Médicos sin Fronteras y Salud por Derecho no se hicieron esperar: “Consideramos que esta aportación queda muy lejos de las necesidades del Fondo, no se corresponde con la urgencia que sigue representando la pandemia en el mundo y, además, es poco consecuente con los compromisos asumidos por España en la ONU en 2011 para alcanzar la cobertura universal de tratamiento (15 millones de personas) en 2015”.

A las once de la mañana, centenares de activistas se dirigieron a la Casa Blanca desde el centro de convenciones de Washington donde se celebra la conferencia para participar en una marcha por el fin de la epidemia del VIH —Obama confirmó el pasado jueves que no asistiría al congreso, hecho que ha disgustado enormemente a los asistentes—. “Llega gente desde cinco puntos distintos de la capital y nos juntaremos frente a la residencia del presidente”, señaló uno de los manifestantes, Trevor Mitts. “No nos lo creemos, no creemos en la guerra de medicinas que está habiendo porque solo es una cuestión económica, los responsables políticos deben ser más responsables y eficientes”, señaló una portavoz de la plataforma We Can End Aids.

Las autoridades sanitarias declararon el 12 de septiembre como el Día Mundial del Condón Femenino. “Necesitamos tener acceso a este método de prevención. No seremos capaces de crear una generación libre de sida si mujeres, hombres, jóvenes y transexuales no pueden protegerse. De ahí la importancia de este día”, dijo Jessica Terliwoski, de la Global Female Condom Coalition. http://sociedad.elpais.com/sociedad/2012/07/25/actualidad/1343204375_159535.html

El País (Spain)

Cita global en Washington contra la epidemia del VIH

CAROLINA GARCÍA Washington 23 JUL 2012 - 04:11 CET

La Conferencia Internacional del Sida AIDS 2012 abrió el domingo sus puertas en la ciudad de Washington ante una gran expectación por parte de médicos, especialistas, trabajadores del sector y activistas, que han acudido con la esperanza de encontrar el camino para erradicar definitivamente la epidemia. Las aproximadamente 21.000 personas que, según los organizadores, participarán hasta el próximo viernes 27 en el evento tratarán de aprender a “luchar contra el VIH juntos”, como reza el eslogan oficial y recordó Bertrand Audoin, director ejecutivo de laSociedad Internacional de Sida (IAS, por sus siglas en inglés).

“La primera vez que Washington acogió esta conferencia fue en 1987, tres años después se hizo en San Francisco. Y hoy nos encontramos aquí con una situación totalmente nueva en comparación con entonces; ahora todos los viajeros portadores del VIH pueden entrar en este país y todo gracias a Barack Obama. Ahora podemos luchar todos contra esta enfermedad, unidos. Bienvenidos”, enfatizó Elly Katabira, presidente de la IAS y de este congreso, durante el acto de apertura.

“La historia nos ha enseñado mucho, sobre todo que la inversión en ciencia abre realmente camino contra la epidemia. Uno de nuestros objetivos debe ser eliminar el contagio perinatal, de madre a hijo”, dijo en rueda de prensa previa a la sesión de apertura Diana Havlir, investigadora del Instituto del Sida en San Francisco. Durante este mismo acto, una veintena de activistas en pro de los derechos de los trabajadores sexuales irrumpieron con pitidos y gritos: “Si no les ayuda a ellos, no queremos la ayuda. La ayuda es para todos”. “¿Por qué hacer este congreso en un país en el que dos de cada tres personas con VIH no son tratadas? ¿Por qué?”, preguntó un asistente indignado, sentado entre el público.

“Fue muy importante para mí lograr que la prohibición de entrada a viajeros con VIH terminara en 2009, y ahora me parece igual de importante el haber presentado un proyecto de ley la semana pasada que protege a los trabajadores sexuales, a los transexuales y a aquellos que se inyectan droga. Es fundamental que sean parte de esta solución”, aclaró Barbara Lee, congresista demócrata. “Todavía hay demasiadas personas que se infectan y demasiada gente que no tiene acceso al tratamiento”. Ayer se celebró también una manifestación desde el monumento a George Washington para reclamar que todos los viajeros con VIH puedan moverse a cualquier país del mundo.

“Es muy importante para nosotros estar en Washington en un momento en el que podemos terminar con la epidemia para siempre. Necesitamos luchar contra el estigma, la criminalización, no se pueden perder esas perspectivas”, añadió Michel Sidibé, director de UNAIDS, la agencia de Naciones Unidas que lucha contra la enfermedad. Sidibé puntualizó la importancia de no olvidar la relación que existe entre el VIH y otras enfermedades como el cáncer de útero o la tuberculosis. “Tenemos la clave para que en cinco años haya por fin una generación libre de VIH y eso exige una obligación y trabajo arduo por parte de los distintos organismos involucrados, incluyendo la necesidad de invertir”.

95 La XIX Conferencia Internacional del Sida, que ha contado también con la asistencia del presidente sudafricano, Kgalema Motlanthe, y del secretario general de Naciones Unidas, Ban Ki-moon, ha dado comienzo a las seis de la tarde (medianoche en la España peninsular) con una serie de cortos sobre la problemática de la enfermedad: parejas gais, latinos o mujeres afroamericanas hablando sobre el tratamiento, el estigma o la criminalización. Vivencias personales que han mostrado la realidad de una enfermedad que sufren unos 33 millones de personas en el mundo –tan solo 10 tienen acceso al tratamiento-.

Sharon Stone ha intervenido para presentar el premio Elizabeth Taylor a los derechos humanos, en honor de la fallecida actriz, que dedicó parte de su vida a la lucha contra el sida. El galardón fue para dos hermanos, los doctores iraníes Kamiar y Arash Aralei, cuyo trabajo de prevención y tratamiento del sida y la drogadicción en Irán les llevó a tener centros en 67 ciudades del país y estar presentes en 57 prisiones, y provocó su polémico arresto en 2008 durante la Conferencia de Sida de México, acusados de conspirar contra su Gobierno. Kamiar pasó dos años y medio en prisión; su hermano, tres. “Tratar el sida no es un crimen”, ha sostenido Arash Aralei. “Como médico, me encanta ver cómo los distintos especialistas trabajan juntos para luchar contra esta enfermedad, porque la solución es un esfuerzo global de todos”.

A continuación, una serie de vídeos han mostrado la labor que se realiza día a día en Estados Unidos para luchar contra el sida. Desde San Francisco, donde sus programas educativos son pioneros, hasta Chicago, donde gracias a la Health Foundation of AIDS muchos enfermos sin hogar tienen acceso a tratamiento.

Durante su discurso, el alcalde de Washington, Vincent Gray, ha agradecido la labor de todos los voluntarios y asociaciones que están ayudando a erradicar la infección del VIH en el Distrito de Columbia. “Esta enfermedad tiene mucho impacto en nuestra comunidad y debemos seguir trabajando duro. Ayer mismo se repartieron más de cinco millones de condones en toda la ciudad: en colegios, asociaciones, por las calles e incluso en las iglesias. Y ningún bebé ha nacido aquí infectado desde 2009”.

La Secretaria de Sanidad, Kathleen Sebelius, ha anunciado un nuevo plan estratégico basado en cuatro nuevas iniciativas para continuar con el esfuerzo estadounidense de lucha contra el sida. Por primera vez existirá una única solicitud de tratamiento para estos enfermos; desde el próximo 1 de septiembre, habrá un programa de ayuda denominado UCARE4LIFE, en el que los pacientes podrán resolver sus dudas; además, las farmacias elaboran un protocolo de actuación para conseguir que los portadores del VIH sean responsables con sus tratamientos. Y por último, se educará mejor a los profesionales de la salud.

“Estoy aquí para lanzar un desafío, debemos buscar todos el mismo Objetivo, la erradicación total de esta epidemia”, ha asegurado Jim Yong Kim, presidente del Banco Mundial. Durante los cinco días que durará el congreso, se hablará de cómo conseguir fondos, de los elementos de lucha que implican al VIH, de la existencia de nuevos fármacos -no solo para este virus sino también para la tuberculosis- y también de nuevos datos epidemiológicos. “Me planto aquí ante vosotros porque tengo 24 años y vivo con el VIH, por ello, uno de los objetivos principales de los que se va a hablar en esta Conferencia es la necesidad de que los jóvenes y las mujeres tengan acceso a los servicios de salud, porque son ellos son los que pueden detener la epidemia”, ha sostenido Annah Sango, activista de la lucha contra el sida en Zimbawe. Sebelius ha sido la encargada de cerrar el evento.

Europe 1

Sida : "l'épidémie pourrait avoir disparu en 2050" (E1)

Par Europe1.fr Publié le 20 juillet 2012 à 19h03Mis à jour le 20 juillet 2012 à 19h04

Françoise Barré-Sinoussi, prix Nobel de médecine et co-découvreuse du virus du sida, a expliqué sur Europe 1 à l'occasion de la dix-neuvième conférence internationale sur le sida à Washington, aux Etats-Unis, que "des systèmse de modélisation disent que si on arrive à favoriser l'accès universel des traitements actuels disponibles, l’épidémie pourrait avoir disparu en 2050".

D'ici là, les recherches se poursuivent, principalement pour permettre une guérison totale du virus du sida. "Comme ce virus est caché, il n’est pas atteignable par traitements actuels", a expliqué Françoise Barré-Sinoussi. "La recherche s’oriente vers des traitements qui vont réactiver les cellules du à l'état dormant et y associer en même temps des stratégies pour stimuler la défense immunitaire, pour éliminer les cellules infectées et aussi empêcher les cellules d’être réaffectées. Ce sont donc trois cibles qui font l’objet d’investigations". Et d'ajouter : "les résultats sont encourageants mais montrent qu’il faut aller vers des combinaisons thérapeutiques".

La Nobel de médecine a par ailleurs indiqué que "la recherche a besoin d’argent. Cette recherche de nouveaux traitements va coûter cher. On ne sait pas encore combien. Ce qu’on essaye aussi, c’est de travailler au niveau mondial pour accélérer cette recherche et qu'elle coûte moins cher que si on travaille de façon dispersée". http://www.europe1.fr/France/Sida-l-epidemie-pourrait-avoir-disparu-en-2050-E1-1177171/

Forbes

AIDS Cure: Hype or Hope Gets Hearing at AIDS Conference

Michael Waldholz, Contributor PHARMA & HEALTHCARE 7/23/2012 @ 2:19PM |1,550 views

Is the end finally in sight for the 30-year old AIDS pandemic?

That question, audacious as it sounds, is being seriously raised this week in Washington where the giant biennial international AIDS conference, called AIDS2012 and attracting over 2,000 people, is meeting under the organizers’ unambiguously optimistic theme, “Turning the Tide Together.” In sessions that began yesterday key leaders in the decades-long battle spoke, seriously for the first time, about achieving a cure. To me, however, the challenge to control the disease’s spread appears almost as daunting as ever. Any mention of the word “cure,’’ even with all the caveats, feels as daunting as ever. Thirty-four million people around the world carry HIV. The cost of treating all of them and preventing new infections is unrealistic, expected to rise to $24 billion annually in 2015, and as high as $35 billion a year by 2031.

Despite this, sessions at the meeting have clearly been designed to recognize and applaud notable gains. I have covered the pandemic on an off for the past three decades, first as reporter at the Wall Street Journal and then as managing editor at Bloomberg News, and have attended many of these meetings. From that perspective, the successes being described can’t be diminished, as some are truly startling. Combination drug therapy called ARTs, first developed in 1996, now allow infected people to live long and normal lives. There are 30 different drugs now from Gilead, Abbott, Merck, Bristol-Myers and others, many available in less expensive generic versions. Dramatically discounted drug prices are making the regimen affordable to millions of people in poor nations for whom the treatments were out of reach just a few years ago. And powerfully new insights are emerging about how the virus evades the immune system and carries out its destruction. There even is persuasive evidence that HIV-infected people who conscientiously remain on their daily therapy can reduce the risk of passing the virus to sex partners by 96 percent. This alone is spurring a call to action as it provides powerful evidence that there is at hand a real way to slow the disease’s spread.

Of particular interest, a working group of 34 basic scientists and doctors have been meeting regularly with activists and others, though with little publicity over the past 18 months, to lay out a detailed global collaborative research agenda. The group maintains that if the scientific projects they have mapped out are fully funded, many stubbornly persistent mysteries that have allowed the virus to elude eradication may be solved.

In his opening speech yesterday, Dr. Anthony Fauci, who has been the U.S. government’s leader in the fight against HIV/AIDS from the pandemic’s beginning, rallied the packed meeting hall with bold words. “We now have the scientific tools to turn the tide of the HIV/AIDS epidemic and dramatically alter the trajectory of the pandemic towards the ultimate goal of an AIDS-free generation,’’ he said. “We have a moral responsibility to do so.” The question he raised, and its no small matter, is whether there is a commitment, meaning the money, to support a global scale up successful programs to meet that goal.

Dr. Elly Katabira, AIDS2012 International Chair and President of the InternationalAIDS Society (IAS) which sponsors AIDS2012, echoed a distinctly similar call: “We now have the scientific tools to turn the tide of the HIV/AIDS epidemic and we need to seize that opportunity before us,” he said. To be fair, Fauci pointed out that the public should understand the idea of ending the pandemic is different from a cure. The science still doesn’t exist to create a vaccine, though teams of scientists are still pursuing it.

The question is whether these statements, repeated by other speakers, deserves the palpably buoyant energy being generated in Washington, the first time in 20 years that the biennial global conference is being hosted in the U.S. after the lifting of an indefensibly stupid ban against U.S. visas for known HIV-infected travelers. The positive vibes clearly aren’t spontaneous or serendipitous, but is being consciously assembled by meeting organizers to re-engage the media, government and private donors, policymakers, researchers, activists and doctors. Despite the recent advances, including the first cure of an infected individual dubbed “the Berlin patient,’’ the organizers are clearly acknowledging that it has been a challenge, especially given the global economic turmoil, to spur public and private engagement. AIDS is no less the nightmare it was 10 years ago, but stirring the world to keep up the siege is a hurdle that to my mind may be insurmountable.

One of the most sobering statistics, and one that clearly creates much skepticism about Fauci’s goal, was described by Dr. Kevin Fenton, who heads the HIV program at the U.S. Centers for Disease Control. In a pre-conference roundtable, Fenton said that in the U.S., where the resources clearly exist, one out of four of the estimated 800,000 infected Americans, haven’t been diagnosed or under treatment. Given the evidence that treated individuals are at low risk of transmitting the disease, the data here are depressing. If the turning tide goal is failing in the U.S. how likely will it be accomplished elsewhere. Fenton himself acknowledged, “We have a lot of work to do.’’ The epidemic among blacks gay men in America is especially depressing, as pointed out today in Bloomberg News. One in four black gay men by age 25 in the U.S. are infected and that rises to 50 percent in this population group by age 50. Among these, the “epidemic is raging,” said Phill Wilson, president of the Black AIDS Institute.

I will be covering the meeting, attending several days of the session, and plan to write about the whether the fight against HIV/AIDS is indeed at a turning point. Stay tuned. http://www.forbes.com/sites/michaelwaldholz/2012/07/23/aids-cure-hype-of-hope-gets- hearing-at-biennial-aids-conference/

Forbes

Possible Cure in Two More AIDS Patients as Research Momentum Grows

Rob Waters, Contributor

AIDS-cure research got another boost with two new reports released in conjunction with the AIDS conference in Washington. The intriguing studies point to new avenues for potentially eradicating the virus from infected people.

First, two men who’d been infected with the AIDS virus for years and then were given bone marrow transplants to treat cancer appear to be free of HIV two years and four years after their transplants. Since the men remain on antiviral drugs, doctors can’t be certain the virus won’t return. The doctors who conducted the researcher, from the Harvard School of Medicine, hope to stop the men’s HIV medications soon to see if they are cured.

In another study, a Merck cancer drug already on the market flushed batches of dormant virus out of hiding places in the tissues of eight HIV-infected men. The research, led by David Margolis at the University of North Carolina and published yesterday in the journal Nature, could lead to a two-part “flush and destroy” approach that draws out residual pockets of HIV and then KO’s them with antiviral drugs.

The new Harvard research is based on the experience of Timothy Brown, whose 2007 treatment made him the only person in the world to be cured of HIV. Like Brown, the two men in the new cases were on antiviral drugs for their HIV when they developed cancer. All three were given chemotherapy to wipe out the cancer, followed by a bone-marrow transplant to rebuild their immune system with cancer-free cells.

Brown’s doctors in Berlin added a unique wrinkle: they found a bone-marrow donor who had a genetic mutation that made him resistant to HIV. The resistance transferred to Brown, eradicating HIV from his system and allowing him to stop taking drugs. It also cured his leukemia. After Brown’s story became known, the two Harvard researchers, Timothy Henrich and Daniel Kuritkes, began to wonder: Was it really necessary to use the cells of a donor with the genetic mutation? Perhaps, they thought, it would suffice to replace a patient’s immune system with cells from any matching donor who wasn’t infected with HIV.

They found the two patients, who’d already gone through a transplant and whose blood and tissue samples had been preserved. This allowed the scientists to hunt for viral DNA from before the transplant and to learn if it vanished afterward. The patients had stayed on antiviral drugs throughout their transplant.

100 That was important because the traces of viral DNA that remain hidden in the tissues of every person with HIV generally roar back to life when people stop their medication. If a patient temporarily stopped taking the drugs during the transplant process, as many cancer patients do to reduce side effects, the viral remnants might infect the new cells coming from the donor, causing HIV to resurface.

The two patients had both been treated for their cancer at Harvard. One, a man in his 20s, was born HIV-infected and has been on drugs his whole life. He developed Hodgkin’s lymphoma and received a bone-marrow transplant four years ago. The second was a man in his 50s who’d been infected with HIV in the 1980s. Starting about a decade ago, he developed AIDS-related lymphoma, then Hodgkin’s lymphoma and received numerous treatments including, eventually, a bone marrow transplant.

The researchers tested banked blood samples and found evidence of HIV-DNA in samples taken before the transplant and two to three months after it. The first man’s viral-DNA levels began to decline 70 days after his transplant and were undetectable at 200 days. The levels fell more slowly in the second man and could no longer be detected by Day 300. The samples also were checked by Michael Busch, director of Blood Systems Research Institute in San Francisco, who told me his tests “support the hypothesis that these patients may have eradicated the virus.” The two patients, who remain anonymous, “know all about the Berlin patient and are excited about the prospects of where this might go,” Henrich said. The next step will be for the two to stop taking antiviral drugs while researchers monitor them with once- or twice-weekly tests to see if the virus returns. The risk of stopping treatment is small because the patients could resume their medications at the first sign of virus, Kuritzkes said. He and his colleagues are talking with the patients and their oncologists about the best time to begin that part of the research.

If it pans out, it would be further proof that curing HIV is possible and that researchers are on the right track. But it would never be a practical way to treat large numbers of patients because the risks of bone marrow transplants are too great and the logistical difficulties and cost associated with them are too high. That’s where the other approach comes in.

A single dose of Merck’s Zolinza reactivated hidden virus in the cells of eight patients, increasing their levels almost five-fold. The work provides “compelling evidence for a new strategy to directly attack and eradicate latent HIV infection,” Margolis said.

Other pharma companies and academic labs are also hunting for drugs that could provide a way to get at the lurking cells in every patient with HIV. It will take a while but researchers hope to give Timothy Brown some company. http://www.forbes.com/sites/robwaters/2012/07/26/possible-cure-in-two-more-aids-patients- as-research-momentum-grows/2/

101

Guardian’s “Sarah Boseley’s Global Health Blog”

French research gives scientists hope of 'functional cure' for HIV

Small group of patients were able to stop taking Aids drugs without any resurgence of the virus in their bodies, study finds

Sarah Boseley, health editor guardian.co.uk, Thursday 26 July 2012 16.23 EDT

A small group of patients with HIV in France have been able to stop taking Aids drugs without any resurgence of the virus in their bodies, giving scientists new hope that a "functional cure" for HIV may be possible.

The Visconti cohort, as the 14 French patients are being called, were all given antiretroviral drugs to control the virus soon after becoming infected with HIV, which is not very common. They remained on medication for at least three years, but then stopped.

Usually, the levels of virus in the body will rise without drug suppression and cause the patient to become ill and eventually develop Aids. But the Visconti cohort has remained well, with extremely low levels of virus in their system, for a median of seven years.

"We believe that this is a really promising group of patients," said Asier Saez Ciron from the Institut Pasteur in France, one of the scientists involved in the research which was presented at the International Aids Conference in Washington.

The existence of people who do not become ill even though they are infected with HIV – the so- called "HIV controllers" – is already known. The excitement felt by scientists over the Visconti cohort is because it appears that medical intervention has brought about similar results. "This is a promise that the functional cure could be achieved," said Saez Ciron.

The work is further evidence that people should be given drugs as soon as possible.

102 "These results suggest that the antiretroviral treatment should be started very early after infection," said Charline Bacchus, lead researcher on the study at the French National Agency for Research on Aids and Viral Hepatitis (ANRS). The study is one of three pieces of work presented at the conference this week that have boosted hopes not of a total cure for HIV, but of what is being called a functional cure, because the virus remains in the body at very low levels but does not cause disease and the patient is able to stop taking medication.

A campaign by scientists to find a cure for Aids has been gathering momentum over the last two years, culminating in a blueprint published just ahead of the conference in Washington. Francoise Barré Sinoussi, Nobel prize laureate for identifying the human immunodeficiency virus (HIV) in the 1980s, is leading the drive, which she says must go hand in hand with efforts to find a vaccine.

Timothy Ray Brown, the so-called Berlin Patient, has been the proof of concept. Brown, who is an American living in the city, had HIV and leukaemia.

When he underwent a stem cell transplant for his cancer, his doctor found a donor who had genetic resistance to HIV. Brown's cancer and his HIV were cured. However, he had serious complications from the treatment, which would be unrealistic and unaffordable for most people.

The conference also heard, however, of two more stem cell transplants that appear to have resulted in functional cures. The two men with HIV had lymphoma, a cancer of the lymphatic system. They underwent stem cell transplantation for the cancer, but this time not involving donors with genetic resistance to HIV. They received mild chemotherapy which allowed them to stay on their antiretroviral medication throughout.

Although HIV was detectable in heir cells immediately after the transplant, over time the uninfected donated cells replaced the infected cells. Both patients appear to be HIV-free, one of them two years and the other three and a half years after their operation.

A third study by David Margolis and colleagues at the University of Carolina, published in Nature, appears to show that it is possible to reach the low levels of virus that "hide" in cells and have never been susceptible to treatment, using a dose of a drug that inhibits an enzyme involved in "silencing" HIV. http://www.guardian.co.uk/society/2012/jul/26/french-study-scientists-hiv

103

Guardian’s “Sarah Boseley’s Global Health Blog”

A cure for Aids?

Posted by Sarah Boseley | Thursday 19 July 2012 15.00 EDT

Scientists today launch a strategy to co-ordinate efforts focused on a cure for Aids, which they say they believe is feasible and the only way to end the epidemic

Most people may assume scientists and drug companies have always been on an all-out hunt for a cure for Aids. Not so. The virus is so elusive and smart that for decades now, experts have hardly dared dream of eliminating it. Most of the effort has gone instead into treatment which keeps it under control in the body and vaccines to stop it getting a hold in the first place.

But now scientists from the International Aids Society (IAS) have decided it is time to go for the cure. It is the best hope of ending the epidemic, they believe. Vaccines are still far off, the cost of treating everybody infected for life – now around 32 million people worldwide – is extraordinarily high and there are long-term effects of the drugs, while prevention efforts based on behaviour change always seem to fall short.

Françoise Barré-Sinoussi, the Nobel prize laureate who was the co-discoverer of the human immunodeficiency virus (HIV), is one of the prime movers in the campaign for a cure, which was launched in the US today ahead of theInternational Aids Conference (organised by IAS), which kicks off officially at the weekend.

Is a cure for Aids possible? When I spoke to her on a visit to London recently, she said she thought so – but it depended on what you meant by "cure". No – she does not think they will find a way to eradicate HIV completely and finally from the body any time soon – but it could be effectively neutralised. She believes they can find what NIAID director Tony Fauci calls "a functional cure".

104 If you can stop the drugs, then the person who has HIV is "functionally cured". There is a minimal amount of HIV remaining but it is undetectable, it does not cause illness and it cannot be transmitted to anyone else. That's the theory.

The inspiration for these scientists is one man who once had HIV but now appears to be cured. This is Timothy Brown, once known only as "the Berlin patient", who now speaks publicly about his game-changing treatment. He had HIV and leukaemia. He underwent a bone marrow transplant for the cancer – and his doctors selected a donor who possessed a gene that made him resistant to HIV infection. Brown now is cured of both cancer and HIV.

Hugely expensive stem cell transplants are not the future, but Brown is "proof of concept" – a man who recovered from HIV infection.

The strategy – Towards an HIV cure – proposes seven priority research areas and six key steps that need to be taken concerning the organisation and conduct of research. The blueprint has taken two years to pull together. It will take a while longer before we have a cure for Aids, but it cannot be too soon to start the hunt. http://www.guardian.co.uk/society/sarah-boseley-global-health/2012/jul/19/hiv-infection- infectiousdiseases?newsfeed=true

105

Guardian (Nigeria)

Scientists Launch Global HIV Cure Strategy

SATURDAY, 21 JULY 2012 00:00 BY CHUKWUMA MUANYA AND JOSEPH OKOGHENUN

AHEAD of the International AIDS Conference starting tomorrow in Washington D.C, United States, scientists yesterday announced the launch of inaugural global scientific strategy towards HIV cure. The launch is coming amid new reports by the Joint United Nations Programme on HIV and AIDS (UNAIDS) and Kaiser Family Foundation that funding for immunodeficiency virus infection/acquired immunodeficiency syndrome (HIV/AIDS) has been the same since 2008 when the global recession hit the world.

The new HIV cure strategy identified seven important priority areas for basic, translational and clinical research as well as maps out a path for future research collaboration and funding opportunities.

Co-discoverer of HIV and Director of the Regulation of Retroviral Infections Unit at the Institut Pasteur, Prof. Françoise Barré-Sinoussi, said that the strategy would go a long way in finding a cure to the virus that has plagued mankind for decades.

“The strategy is the result of a collaborative effort which has produced a roadmap that will constructively move HIV cure research forward,” Barré-Sinoussi said.

Barré-Sinoussi, who is also the International AIDS Society (IAS) President-Elect, with Prof Steven Deeks of the University of California, is co-chair of the group of 34 leading HIV scientists and clinicians who have developed the Global Scientific Strategy.

“The science has been telling us for some time now that achieving a cure for HIV infection could be a realistic possibility. The time is right to take the opportunity to try and develop an HIV cure – we might regret never having tried,” concluded Barré-Sinoussi.

The IAS strategy for an HIV cure has a very clear vision: A safe, affordable and scalable cure will improve the health and quality of life for those with established infection; reduce the risk of transmission of virus to those not infected, and ultimately allow resources to be shifted to other needs.

Executive Director of UNAIDS, Michel Sidibé said finding cure to HIV would help to end the cycle of stigma and discrimination that has become problem part of HIV treatment.

His words: “Finding a cure for AIDS is a critical innovation gap. A cure will bring new hope to people living with HIV and their loved ones and could end the cycle of stigma and discrimination.”

106 Deeks, who expressed optimism on HIV cure, said the strategy might end decades of hopeless search for HIV cure. “Our basic understanding of the mechanisms of HIV persistence in latent reservoirs is far superior than it was a decade ago. We are entering a stage in the epidemic in which we can seriously begin testing drugs that either prevent latency or which force the virus out of its hiding place, make it susceptible to our current drugs, ” Deeks said.

But UNAIDS’ report revealed that international investments sill account for more than half of funding for HIV in Africa. “International investments still account for two thirds of funding for HIV in Africa, the continent most affected by the epidemic. Although more and more countries are increasing domestic investments for HIV, investments from donor governments remain an essential resource, ” Paul De Lay of UNAIDS said. http://www.ngrguardiannews.com/index.php?option=com_content&view=article&id=92955:scien tists-launch-global-hiv-cure-strategy-&catid=1:national&Itemid=559

107

Health Day

HIV Undetectable in 2 Men After Bone Marrow Transplants: Study

But whether procedure or continued medication is responsible remains unclear

By Amanda Gardner HealthDay Reporter July 26, 2012

THURSDAY, July 26 (HealthDay News) -- Following bone marrow transplants, two men infected with HIV no longer have any traces of the AIDS-causing virus in their lymphocytes, researchers report.

Lymphocytes are a type of white blood cell and are a key part of the immune system. The U.S. researchers suspect that bone marrow transplantation along with continuation of antiretroviral therapy resulted in the dramatic effects evident eight months post-transplant. They are scheduled to present these preliminary findings Thursday at the International AIDS Conference in Washington, D.C.

HIV patients on antiretroviral therapy often achieve "undetectable viral loads," meaning there are no virus particles in their blood. But they still have latent HIV in their lymphocytes, and if antiretroviral therapy were discontinued, the latent HIV could reactivate.

But having no traces of HIV in these white blood cells is an indication that this "reservoir" of latent HIV may have been eliminated, the researchers believe.

At this point, they are far from saying these patients are cured. But the findings are "exciting," said Dr. Savita Pahwa, director of the Center for AIDS Research at the University of Miami Miller School of Medicine, who was not involved with the study.

"Every hint you get that it's possible to wipe out the reservoir needs to be investigated," she said. "Eliminating the reservoir is the key to the cure," said Pahwa. She also stressed that it would only be possible to say these patients were "functionally cured" if the virus did not rebound when the patients went off antiretroviral therapy.

The two men whose cases are described in the paper underwent chemotherapy for blood cancers before receiving stem cell transplants. One had his transplant two years ago; the other, four years ago. Both also developed graft-versus-host disease (when transplanted cells attack the host cells) and continued with their antiretroviral medications throughout and after the transplant procedures.

Any of these factors could theoretically explain their HIV-free status, but the bone marrow transplantation combined with antiretroviral therapy seems the most likely explanation, said the study authors.

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"We believe the transplanted cells killed off and replaced all of the patients' own lymphocytes, including the infected cells, and the donor cells were protected from becoming infected themselves by the antiretroviral therapy they were taking throughout the transplant period," said study senior author Dr. Daniel Kuritzkes, chief of infectious diseases at Brigham and Women's Hospital and professor of medicine at Harvard Medical School in Boston.

Graft-versus-host disease also probably played a role, he said. "The replacement of host cells by donor cells is itself a form of graft-versus-host reaction," Kuritzkes explained.

But the only way to verify that the transplant plus antiretroviral therapy can eradicate HIV is to take the patients off their medication regimens.

That would be the "next logical step," said Kuritzkes, adding that this would require patient consent and adherence to ethics protocols.

But even if the transplant procedure were found to eliminate the reservoir of latent HIV cells, bone marrow transplantation is a very risky procedure. Kuritzkes said he does not "foresee bone marrow transplantation being performed on otherwise healthy HIV-infected patients who are doing well on [antiretroviral therapy]."

Kuritzkes and his colleagues are continuing to enroll and follow HIV-positive patients who have undergone bone marrow transplants as part of a larger study.

This preliminary study contains echoes of the so-called "Berlin Patient," who has no detectable HIV cells in his blood five years after a stem cell transplant for leukemia.

Like the two men discussed in the current paper, the Berlin Patient -- Timothy Ray Brown of Seattle -- also had been diagnosed with HIV and also underwent chemotherapy (for acute myeloid leukemia) and developed graft-versus-host disease.

But, unlike the current patients, Brown received his stem cell transplant from a donor who had a rare genetic mutation that increases immunity against the most common form of HIV. He remained HIV-free after discontinuing antiretroviral therapy.

The two men described here received donor cells, which were "fully susceptible" to HIV, Kuritzkes said. This raises the possibility that a cure may be possible even when the donor does not have this gene mutation, he said.

Because this research has not been peer-reviewed and published in a medical journal, the data and conclusions should be considered preliminary. http://health.usnews.com/health-news/news/articles/2012/07/26/hiv-undetectable-in-2-men- after-bone-marrow-transplants-study

109

Huffington Post’s “Healthy Living”

Two Men Are HIV-Free After Undergoing Bone Marrow Transplants

Posted: 07/26/2012 4:59 pm

Two men with HIV no longer have detectable blood levels of the virus after receiving bone marrow transplants for their cancers, according to news reports.

"We expected HIV to vanish from the patients' plasma, but it is surprising that wecan't find any traces of HIV in their cells," one of the researchers, Dr. Timothy Henrich, of Brigham and Women's Hospital, told ABC News. The network reported that the men received the bone marrow transplants while also being treated with anti-retrovirals.

Usually people with HIV are taken off their anti-retrovirals before cancer treatment, NBC News reported.

The finding "suggests that under the cover of anti-retroviral therapy, the cells that repopulated the patient's immune system appear to be protected from becoming re-infected with HIV," Henrich told ABC News.

NBC News pointed out that the men still have undetectable HIV levels even two years after receiving the transplants.

However, the Boston Globe pointed out that it's still too soon to say that these men have been full- on cured of HIV, since they are still on the anti-retrovirals. There's no firm word on whether they will go off of the medication.

Researchers cautioned that this approach probably won't work for everyone with HIV, NBC News reported. The men possessed specific gene mutations, and bone marrow transplants are an arduous process for the patient -- sometimes even fatal -- and they are also extremely expensive, the Boston Globe reported.

"We're not going to be doing bone marrow transplants on healthy HIV-infected patients who are doing well on antiretroviral therapy," study researcher Dr. Daniel Kuritzkes told the Boston Globe.

The findings, presented at the 2012 International AIDS Conference, come just days after Timothy Ray Brown -- the "Berlin patient" who was considered cured of HIV after undergoing a bone marrow stem cell transplant for his leukemia -- said at the conference that any reports that he still has HIV in his body are untrue, the Associated Press reported. Recently, there had been controversy over a presentation suggesting Brown still had traces of HIV genes in his body -- and whether that meant that he actually still had HIV.

Brown initially received the bone marrow stem cell transplants because of non HIV-related leukemia, but the transplants came from a person whose cells were HIV-resistant. After he had

110 received the transplants, Brown's HIV didn't come back and he didn't have to take anti-retroviral medication anymore. Scientists considered him cured.

However, these two new cases are different from Brown's because the two men are still on antiretroviral drugs, while Brown was able to go off of them after his transplant. http://www.huffingtonpost.com/2012/07/26/hiv-free-men-bone-marrow- transplants_n_1707505.html

111

International Business Times

Aids Cure: Two More Men Declared 'Hiv Free' After Bone Marrow Transplant

Late breaking revelation at International AIDs Conference in Washington gives hope that a cure for the disease could be attainable.

By NICHOLAS EDMONDSON: Subscribe to Nicholas's RSS feed July 27, 2012 9:14 AM GMT

Two men have been declared free of HIV following a bone marrow transplant to treat cancer, adding to hope that a cure for the disease could be achievable.

Scientists at the International Aidss conference in Washington, revealed that the men were found to have no detectable levels of the virus in their blood or cells.

The results for the two men, both treated in a Boston clinic, mirror those of Timothy Brown, the "Berlin patient" who is the only known person to have been cured of Aids.

One of the researchers, Dr Timothy Henrich, of Brigham and Women's hospital, told ABC News: "We expected HIV to vanish from the patients' plasma, bit it is surprising that we can't find any traces of HIV in their cells."

Brown is a gay US citizen who was diagnosed with HIV in 1995. He maintained his drug treatment regime in order to stop the virus developing into Aids. He was diagnosed with myeloid leukemia in 2006 and was given a bone marrow transplant.

The transplant was taken from a donor who had a natural mutation to the gene that ordinarily aids the spread of HIV cells. Brown was found to have no trace of HIV cells inside his body following the treatment.

Scientists stressed that the two men in Boston are not completely cured of the disease, which could remain in their body in undetectable quantities.

Dr Daniel Kuritzkes, who also oversaw the study, told NBC News: "We're being careful not to do that [tell the men they are cured]. We are not saying, 'You are like the Berlin patient'."

Both of the patients were sufferers of Hodgkin's Lymphoma, while one also had other blood cancers. They received mild chemotherapy and maintained their HIV medication throughout their treatment before having bone marrow transplants.

The scientist who studied the patients believe this was a key aspect, as the antiretroviral drugs were able to protect the donated marrow from HIV while it rid the body of cancer.

112 Within nine months of their transplants the men were found to have no trace of HIV, even in the smallest genetic building blocks.

The findings will add weight to a call by Françoise Barré-Sinoussi, one of the first to idnetify the Aids virus, who has called for a new cure-based global strategy for Aids treatment. Although bone marrow transplants are too expensive and risky as a treatment for all Aids patients, and the two men differ from Brown in that they must continue their antiretroviral drug regime, the findings provide further ground for progress towards a cure.

Further studies The conference also heard about a small group of HIV patients in France who were able to stop their drug regime without any resurgence of the virus.

The group of 14 patients, dubbed the "Visconti cohort", were given treatment with antiretroviral drugs as son as possible after infection, which then continued for three years, before being stopped. Despite stopping the treatment, the cohort's HIV virus levels did not increase, maintaining low levels in their system.

Asier Saez Cireon, from the Institute Pasteur in France, said the research was exciting as it showed that medical treatment could create a state mirroring that of the already known 'elite controllers' - rare cases of people infected with the disease who do not become ill.

http://www.ibtimes.co.uk/articles/367459/20120727/aids-cure-hiv-free-two-men-boston.htm

113

Independent (UK)

HIV cure research 'must not jeopardise existing projects'

STEVE CONNOR | FRIDAY 20 JULY 2012

The adoption of a new scientific Aids strategy to cure HIV rather than simply treat it with drugs for many years should not divert funding away from existing anti-Aids projects, a Nobel prize-winning scientist said yesterday.

Professor Françoise Barré-Sinoussi, who shared the Nobel prize for co- discovering the Aids virus, said that a cure for HIV had become a possibility in the light of evidence that it was possible for people to shrug off infection without the long-term help of anti-retroviral drugs.

"The science has been telling us for some time that achieving a cure for HIV infection could be a realistic possibility. The time is right to take the opportunity to try and develop an HIV cure – we might regret never having tried," Professor Barré-Sinoussi said. Speaking last night at a conference in Washington to launch a strategy document on "HIV cure research", Professor Barré-Sinoussi warned that nothing must jeopardise existing measures aimed at treating and preventing HIV infection.

"Under no circumstances should the inclusion of 'cure' in the global response direct funding away from treatment, prevention and care programmes, or from biomedical research on HIV and its consequences, including vaccine and other prevention research," she said.

Professor Barré-Sinoussi, who carried out her Nobel prize-winning research at the Pasteur Institute in Paris, is the president-elect of the International Aids Society, which last year convened a group of 34 leading HIV researchers to formulate a strategy for the discovery of a cure.

The strategy highlights the case of Timothy Brown, the "Berlin Patient", who is the first person to be cured of HIV following two bone-marrow transplants to treat leukaemia. http://www.independent.co.uk/news/science/hiv-cure-research-must-not-jeopardise-existing- projects-7960109.html

114

La Croix (France)

Une conférence pour « en finir » avec l’épidémie de VIH/sida

22/7/12 - 18 H 25

« Il est possible d’en finir avec l’épidémie. » C’est avec ce mot d’ordre volontariste que s’est ouverte dimanche 22 juillet, à Washington, la 19econférence internationale sur le sida, qui devrait rassembler, jusqu’au vendredi 27 juillet, près de 25 000 médecins, chercheurs, responsables d’ONG et leaders politiques.

Organisé tous les deux ans, ce grand rassemblement de la « planète sida » se produit cette année à un tournant de l’histoire de la maladie. Jamais, jusque-là, le message sur une possible éradication de l’épidémie n’avait été martelé avec autant de vigueur. Et jamais les bonnes nouvelles n’ont été aussi nombreuses à l’ouverture d’une conférence internationale.

UN FORT RECUL DE LA MORTALITÉ LIÉE AU SIDA Il y a quelques jours, l’ Onusida a annoncé qu’un « nombre record » de personnes vivant avec le VIH avait désormais accès aux traitements. Fin 2011, on en recensait 8 millions, soit 20 % de plus qu’en 2010. Pour mémoire, on peut rappeler qu’il y a dix ans, seulement 400 000 personnes étaient sous traitement.

De manière logique, la mortalité liée au sida a largement reculé au cours des dernières années. Certes, le virus a encore tué 1,7 million de malades l’an passé. Mais le nombre de décès est en recul de 24 % par rapport à l’année 2005 et même de 31 % en Afrique subsaharienne.

C’est en s’appuyant sur ces bonnes nouvelles que les participants à la conférence de Washington veulent convaincre les dirigeants politiques de la nécessité de poursuivre la dynamique engagée ces dernières années.« On a la preuve qu’investir dans la lutte contre le sida permet d’aboutir à des résultats concrets. Ce n’est pas le moment de baisser la garde »,affirme Bertrand Audoin, directeur exécutif de la Société internationale du sida (IAS).

MAINTENIR LA VOLONTÉ POLITIQUE ET L’ENGAGEMENT FINANCIER Le message, adressé depuis Washington aux grands bailleurs de fonds, est clair : continuer à s’engager massivement dans l’accès aux soins, c’est ouvrir l’espoir vers une possible éradication de l’épidémie. En effet, on sait aujourd’hui qu’un traitement bien administré permet de réduire de façon très importante la quantité de virus dans l’organisme d’un patient et, du même coup, sa capacité à transmettre le virus.

Si la communauté internationale parvenait à traiter les 15 millions de personnes dans le monde qui ont besoin de l’être, la courbe de l’épidémie pourrait donc être stoppée de façon spectaculaire. « Pendant des années, on nous a dit que financer la lutte contre le sida était un puits sans fond. Aujourd’hui, ce discours ne tient plus, et l’éradication de l’épidémie n’est plus une utopie », martèle Francesca Belli, responsable du plaidoyer à l’association française Aides.

115 Les différents leaders qui viendront à Washington seront donc attendus au tournant. En 2011, les financements internationaux contre le sida ont atteint 8,2 milliards de dollars (6,7 milliards d’euros). Mais de nombreux acteurs de la lutte contre la maladie craignent que la crise économique ne vienne entraîner une stagnation, voire une baisse des crédits engagés par les pays riches. « Aujourd’hui, la lutte contre le sida est plus que jamais une question de volonté politique », affirme Francesca Belli qui, comme beaucoup ici, ne cache pas sa déception face à l’absence annoncée du président américain Barack Obama, qui devrait toutefois envoyer un message vidéo « C’est la secrétaire d’État Hillary Clinton qui viendra à sa place, souligne un journaliste américain. Aujourd’hui, Obama est surtout préoccupé par la campagne pour sa réélection. Et comme il n’a pas tenu tous ses engagements sur le sida, je crois qu’il a peur d’être un peu chahuté par les associations. »

P. B. à Washington http://www.la-croix.com/Actualite/S-informer/Monde/Une-conference-pour-en-finir-avec-l- epidemie-de-VIH-sida-_EG_-2012-07-22-834027

116

Le Monde (France)

ENDIGUER LA PANDEMIE DE SIDA N'EST PLUS UNE UTOPIE

LE MONDE | 23.07.2012 A 11H55 • MIS A JOUR LE 23.07.2012 A 13H52 PAR PAUL BENKIMOUN (WASHINGTON, ENVOYE SPECIAL)

Et si c'était le tournant tant attendu ? Dimanche 22 juillet, s'est ouverte la 19eConférence internationale sur le sida, à Washington. Plus de 22 000 chercheurs, médecins, responsables politiques, militants associatifs y participent. Un mot d'ordre : "Ensemble, renverser la tendance." Car l'idée que le monde dispose à présent de suffisamment d'outils d'intervention pour pouvoir espérer arrêter une épidémie qui a fait plus de 30 millions de morts depuis les premiers cas découverts en 1981 n'est plus une utopie.

L'Onusida a publié, le 18 juillet, un rapport intitulé "Ensemble nous pouvons en finir avec le sida" (en anglais), qui témoigne des étapes franchies, détaille les moyens d'intervention découlant des progrès scientifiques et pointe les transformations dans la société des pays les plus touchés. Les avancées sont encourageantes, mais elles ont des limites : il y a bien une diminution des nouvelles infections chez les adolescents et les adultes, mais ce recul n'est pas assez rapide, estime le rapport, qui rappelle que chaque minute, une jeune femme est infectée par le VIH dans le monde.

15 MILLIONS DE TRAITEMENTS D'ICI À 2015 De même, l'Onusida juge qu'il faut faire davantage pour parvenir à diminuer de moitié les infections par voie sexuelle et pour réduire la transmission chez les utilisateurs de drogues par voie injectable. Cela suppose de surmonter plusieurs obstacles, à commencer par la stigmatisation et la discrimination dont sont toujours victimes les personnes séropositives. Mais le document insiste aussi sur la responsabilité de lois punitives qui éloignent des populations vulnérables, comme les personnes qui se prostituent et les usagers de drogues injectables, de l'accès à la prévention et au traitement.

117

Actuellement, dans les pays à revenus faible ou intermédiaire, moins de la moitié des personnes infectées par le VIH reçoivent des médicaments antirétroviraux, soit environ 8 millions d'individus. La communauté internationale s'est fixé pour objectif d'atteindre 15 millions de traitements fournis d'ici à 2015. Un objectif que le secrétaire général des Nations unies, Ban Ki-moon, juge atteignable. A condition de trouver l'argent pour cela. L'ONU estime qu'il faudrait mobiliser 24 milliards de dollars (19,7 milliards d'euros) pour la lutte contre le sida dans les pays à revenu faible ou intermédiaire à l'horizon 2015. Il manque aujourd'hui 7,2 milliards de dollars pour y parvenir. Les pays touchés par l'épidémie ont cependant réalisé des efforts importants, et leur investissement financier dépasse maintenant celui des bailleurs internationaux. Quarante pays à revenu faible ou intermédiaire assument sur leurs propres deniers plus de 70 % de leur réponse nationale au sida.

INITIATIVES PORTEUSES D'ESPOIR De nouvelles initiatives continuent d'alimenter l'espoir. Comme celle lancée le 19 juillet par l'International AIDS Society (IAS) et portée par la voix de sa nouvelle présidente, Françoise Barré- Sinoussi : "Towards an HIV Cure" ("Vers un traitement contre le VIH"). Cette initiative s'appuie en partie sur le cas du "patient de Berlin". En 2007, Timothy Brown, qui vivait avec le VIH, a reçu une transplantation de cellules souches de la moelle osseuse provenant d'un donneur faisant partie de ce petit nombre d'individus qui sont naturellement résistants à l'infection par le VIH. Timothy Brown a alors cessé son traitement antirétroviral et, depuis cinqans, il ne présente aucun signe biologique d'infection. "En d'autres termes, il est guéri. Son expérience laisse penser que l'infection par le VIH pourrait être un jour curable", écrivent le Prix Nobel Françoise Barré-Sinoussi etSteven Deeks (Université de Californie, San Francisco) dans la revue Naturedatée du 19 juillet.

Mais là encore, avant qu'un traitement puisse être mis au point, des moyens financiers devront être mobilisés. "Il est clair que davantage de ressources – peut-être des centaines de millions de dollars annuellement – seront nécessaires pourtrouver un traitement", estiment les deux scientifiques. Des sommes importantes sont déjà consacrées aux travaux sur les traitements par les Instituts nationaux de la santé (NIH) américains ou l'Agence nationale de la recherche sur le sida et les hépatites virales (ANRS) française – respectivement 46 et 7 millions d'euros.

La conférence de Washington sera donc un test pour la réponse que les gouvernements et institutions sont prêts à apporter à la lutte contre le sida au moment où les scientifiques ne leur ont jamais donné autant de solutions pouragir. http://www.lemonde.fr/sante/article/2012/07/23/endiguer-la-pandemie-de-sida-n-est-plus-une- utopie_1737062_1651302.html

118

MedPage Today

Studies Hint at Strategies to Cure AIDS

By Ed Susman, Contributing Writer, MedPage Today Published: July 27, 2012

WASHINGTON – Two new human studies offer hints that there may be pathways that can lead to a cure for HIV, the virus that causes AIDS, researchers said here at the International AIDS Conference. In one study, two patients achieved almost complete eradication of HIV throughout their body after they underwent allogeneic stem-cell transplantation. However, Dan Kuritzkes, MD, of Brigham & Women's Hospital/Harvard Medical School, who discussed his group's study at a press briefing, said he couldn't call the patients cured because they were still on antiretroviral therapy.

In a second study, French researchers from the Agence Nationale pour le Recherche sur le Sida said that six of eight patients remained off-treatment and in control of their virus following a regimen in which they were treated within 10 weeks of infection, then had suppressive therapy for a year, and then interrupted therapy. These patients have remained free of viral rebound for as long as 6 years, said Asier Saez-Ciron, MD, from Institut Pasteur, Paris.

"Cure research has basically shifted from the lab and into the clinic," Steven Deeks, MD, of the University of California at San Francisco, told MedPage Today. "Now it is up to the clinical trialists to begin to take these ideas and move them forward."

"The enthusiasm is not that we are going to have a cure any time soon. The enthusiasm is that it is now possible and there is a group effort aimed in this direction," he said. "No one thinks that this is going to be easy, but that it is possible, and now there is global buy-in. It could take decades unless we get really lucky. This is going to be a trial of errors and is probably going to require combination therapy -- but we have gotten lucky before."

Although most highly active antiretroviral therapies are effective in lowering HIV to undetectable levels for years, numerous studies have found that once treatment stops, the virus rebounds quickly, strongly, and inevitably.

Kuritzkes and colleagues were attempting to replicate the so-called "Berlin patient" who, after stem-cell transplantation from a donor whose stem cells had natural immunity to HIV infection, has been free of HIV without being on medication for 5 years.

He and colleagues gave stem-cell transplants to two long-term HIV patients in a way that allowed them to remain on antiretroviral therapy throughout the process. A very sensitive test showed that tiny amounts of HIV remained in their bodies before and after the transplant, but -- as the transplanted cells developed into a new immune system -- the traces of HIV declined and now cannot be found.

119 In a sense, Kuritzkes said, the presence of antiretroviral therapy throughout the process amounted to "pre-exposure prophylaxis for a new immune system."

The French experiments were an attempt to create long-term so-called elite-controllers who are infected with HIV but have essentially undetectable virus without antiretroviral therapy. Seaz-Ciron reported that in the so-called VISCONTI patients in his study, "treatment initiated at primary HIV infection leads, after treatment interruption, to a low – but inducible – durable HIV reservoir distributed mainly in short-lived memory CD4-positive T cells that mimic the natural distribution observed in elite-controllers."

David Margolis, MD, of the University of Pennsylvania in Philadelphia, another prominent researcher in attempts to find a cure for HIV, said at the press briefing, "We are very careful about what we say. We define cure in several different ways and the different kinds of cure and eradication therapy mean different things to different people."

"Perhaps we should come up with a different term like 'complicated eradication chemoimmunotherapy' to slow people down," he jested.

"But this is where the field is headed," he said, returning to the seriousness of the topic. "You can't argue about the value of the goal, and I can't say how long it will take." He cautioned, however, that even if eradication is achieved, "people can get infected again."

Deeks, citing the long road from zidovudine monotherapy in 1987 to effective combination therapy a decade later, said he would be "shocked" if a cure could be achieved in the same time frame. "My feeling is that the barriers to a cure are far greater than that to achieve combination therapy and it is going to take much longer to get there."

"What we are going to see over the next few years will be a number of pilot-type studies that will identify potential hits and then go from those promising results into further studies, and that is going to take well over a decade."

The press briefing and the new study presentations were preceded by a 2-day symposium that reviewed work in the field. http://www.medpagetoday.com/MeetingCoverage/IAC/33944

120

MedPage Today

'Ending AIDS' on IAC Agenda

By Michael Smith, North American Correspondent, MedPage Today | Published: July 20, 2012

WASHINGTON, D.C. -- Unprecedented optimism surrounds the 19th International AIDS Conference, starting here next week. It will not mark the end of the pandemic, but the first AIDS conference on U.S. soil in 22 years may well be the beginning of the end. "We're talking about ending AIDS," says conference co-chair Diane Havlir, MD, of the University of California San Francisco. That's not to say the road ahead is clear, she told MedPage Today earlier this year in a wide-ranging interview. But there is a growing sense that many of the tools needed to slow and stop the pandemic are either in hand or under development. What it will take, as always, is the political, financial, and social will to get the job done. The meeting's theme – Turning the Tide Together – is intended to emphasize the need for a global commitment to end the pandemic, according to Elly Katabira, MD, president of the International AIDS Society, which organized the conference. "The past few years have been a scientific watershed in the life of the HIV/AIDS epidemic," Katabira said in a statement, "one that has given us the tools to potentially make major inroads into the epidemic on an unprecedented scale." As usual, the conference will get visits from a range of luminaries, including U.S. Secretary of State Hillary Clinton and former first lady Laura Bush. All told, some 25,000 delegates are expected to attend and they will focus on basic and clinical science, as well as the epidemiology of HIV/AIDS, and social and programmatic sciences. Havlir recalls the 13th conference, held in Durban, South Africa, in 2000, as a major turning point. From that meeting, she says, came a "global commitment to treatment" of HIV, followed by increasingly successful efforts to bring therapy to all who need it. Indeed, the Joint United Nations Programme on HIV/AIDS (UNAIDS) reported this week that more than 8 million people are getting treatment, up from about 5.7 million in 2009. She's hoping the Washington meeting will lead to a similar commitment – this time to end the pandemic. "We're at a very, very exciting place," she said. "There is great optimism." That said, HIV has a way of defeating the most optimistic. In 1996, researchers and clinicians thought that drug cocktails – highly active antiretroviral therapy, or HAART – would put the virus on the run.

121 It didn't take long before they found that the therapy was not a cure and the initial optimism was dashed – so much so that for years scientists avoided using the word 'cure' in connection with HIV. But what HAART does do is keep people alive. And decades of drug development now mean that relatively simple and easy-to-take regimens are more and more widely used. New data on those approaches is expected here. The meeting will also grapple with issues of HIV and aging – an aspect of the pandemic that would have seemed almost science fictional the last time this meeting was held in the U.S. At that meeting -- in 1990 in San Francisco -- the picture was one of almost unrelieved gloom. There were few treatments and they were not very effective. An HIV diagnosis seemed to be a death sentence. Prevention of HIV was certainly possible – condoms and abstinence were and remain highly effective ways of avoiding HIV. But despite early optimism, there was no vaccine. It would be 6 years before the advent of HAART and a decade before the Durban conference charted a way forward toward universal treatment. Now, however, major clinical trials have shown that treatment itself is a preventive tool. In heterosexual couples where one partner is HIV-positive, treating that person almost completely eliminates the risk of transmitting the virus to the uninfected partner. And other studies have shown that giving an anti-HIV drug to uninfected people at high risk of catching HIV also markedly cuts the danger. The issue that will absorb a lot of attention at the Washington meeting, Havlir says, is "how to implement treatment as prevention." Evidence shows treatment as prevention works and is cost-effective, but it essentially means every HIV-positive person in the world needs treatment to prevent transmission – even if he or she is not yet sick enough to warrant therapy on medical grounds. In a world where we still can't treat all the people who actually need therapy to keep well, that seems like an insuperable and costly obstacle. But, Havlir said, it's a matter of "pay now, or pay later." "If we don't do it now," she said, the cost "is only going to get worse." Treatment as prevention, of course, is only part of the picture. Before the AIDS meeting, many researchers will gather for a 2-day symposium that will focus on prospects for actually curing the notoriously tricky virus. A cure may remain a dream, but many experts – including Nobel laureate Françoise Barré-Sinoussi, PhD, the incoming president of the AIDS society – think that there's now enough knowledge to begin outlining the dimensions of the problem. The same can be said about a vaccine against HIV. After years of disappointing trials, researchers are buoyed by the so-called Thai trial, reported in 2010, which showed a 31% protective effect with a two-stage vaccine. This year's AIDS conference will hear about progress in translating that marginal result into a more robust and useful vaccine.

122

MSNBC

Two more men with HIV now virus-free. Is this a cure?

By Maggie Fox NBC News updated 7/26/2012 2:51:07 PM ET

Two men unlucky enough to get both HIV and cancer have been seemingly cleared of the virus, raising hope that science may yet find a way to cure for the infection that causes AIDS, 30 years into the epidemic.

The researchers are cautious in declaring the two men cured, but more than two years after receiving bone marrow transplants, HIV can't be detected anywhere in their bodies. These two news cases are reminiscent of the so-called "Berlin patient," the only person known to have been cured of infection from the human immunodeficiency virus.

These two cases, presented as a “late-breaker” finding on Thursday at the 19th annual International AIDS Conference in Washington, D.C., are among the reasons that scientists have been speaking so openly at the event about their hopes of finding a cure.

“Everyone knows about this ‘Berlin patient’. We wanted to see if a simpler treatment would do the same thing”, said Dr. Daniel Kuritzkes of Brigham and Women’s Hospital in Boston, who oversaw the study. The widely publicized patient, Timothy Brown, was treated for leukemia with a bone marrow transplant that happened to come from a donor with a genetic mutation that makes immune cells resist HIV infection. The transplant replaced his own infected cells with healthy, AIDS-resistant cells. He is HIV-free five years later.

AIDS patients are susceptible to cancers, but they usually stop taking HIV drugs before receiving cancer treatment. “That allows the virus to come back and it infects their donor cells,” Kuritzkes said.

About 34 million people are infected with HIV, the virus that causes AIDS, globally; 25 million have died from it. While there’s no vaccine, cocktails of powerful antiviral drugs called antiretroviral therapy (ART) can keep the virus suppressed and keep patients healthy. No matter how long patients take ART, however, they are never cured. The virus lurks in the body and comes back if the drugs are stopped. Scientists want to flush out these so-called reservoirs and find a way to kill the virus for good.

Brown, and now these two other men, offer some real hope.

123 Dr. Timothy Henrich and colleagues at Brigham and Women’s Hospital launched a search about a year ago for HIV patients with leukemia or lymphoma who had received bone marrow stem cell transplants. Bone marrow is the body's source of immune system cells that HIV infects and it’s a likely place to look for HIV’s reservoirs.

“If you took an HIV patient getting treated for various cancers, you can check the effect on the viral reservoirs of various cancer treatments,” Kuritzkes, who works with Henrich, said. They found the two patients by asking colleagues at Dana-Farber Cancer Institute in Boston which, like Brigham and Women’s, is associated with Harvard Medical School.

Both men had endured multiple rounds of treatment for lymphoma, both had stem cell treatments and both had stayed on their HIV drugs throughout. “They went through the transplants on therapy,” Kuritzkes said.

It turns out that was key.

“We found that immediately before the transplant and after the transplant, HIV DNA was in the cells. As the patients’ cells were replaced by the donor cells, the HIV DNA disappeared,” Kuritzkes said. The donor cells, it appears, killed off and replaced the infected cells. And the HIV drugs protected the donor cells while they did it.

One patient is HIV-free two years later, and the other is seemingly uninfected three-and-a-half years later.

“They still have no detectable HIV DNA in their T-cells,” Kuritzkes said. In fact, doctors can’t find any trace of HIV in their bodies -- not in their blood plasma, not when they grow cells in the lab dishes, not by the most sensitive tests.

Can the patients be told they are cured?

“We’re being very careful not to do that,” Kuritzkes said.

For now, both men are staying on AIDS drugs until they can be carefully taken off under experimental conditions. "We are not saying, “You are like the Berlin patient’.”

Although the men are HIV-free, Kuritzkes says it's been an arduous experience for them. After being diagnosed HIV-positive, one underwent rounds of chemotherapy for Hodgkin’s disease, a kind of lymphoma, before receiving the final bone marrow transplant, called an allogeneic bone marrow transplant. It is not an easy treatment to endure.

The men, one from Boston and one from New York, were not initially told their HIV had seemingly disappeared. When researchers realized news media would cover the report, they were informed.

Neither man is being identified for privacy reasons but one is in his 50s and has been infected since the beginning of the AIDS epidemic in the early 1980s. The other man, in his 20s, was infected at birth.

124 The findings may not apply to all patients. Both men were a little unusual in that they had a genetic mutation that can make immune cells resistant to infection by HIV. Their new immune cells, however, which came from the donors, are fully susceptible to the virus.

“We’re never really going to be able to do bone marrow transplants in the millions of patients who are infected,” Kuritzkes said. “But if you can stimulate the virus and eliminate those cells, we can protect the remaining cells from being infected.”

Separately, two other studies presented at the conference have scientists optimistic about a cure. In one, a cancer drug called vorinostat flushed out latent HIV from a handful of patients, offering the possibility of killing these latent reservoirs. In another, about 15 French patients who got HIV drugs very early after their infections were able to stop treatment and don’t show any symptoms years later, even though they are still infected.

Organizers of the conference say the findings provide an argument for treating patients early. “(These studies) give us reason for enthusiasm, that ultimately we are going to get to where we needed to go, which is to cure people with HIV infection,” said Dr. Steven Deeks, an HIV expert at the University of California, San Francisco. http://www.msnbc.msn.com/id/48338421/ns/health-mens_health/#.UBG-smEV0rh

125

Nature (UK)

Dormant Hiv Gets Rude Awakening

Researchers tackle virus particles hiding in the immune system as part of efforts to find a cure for AIDS.

Cassandra Willyard 27 July 2012 WASHINGTON DC

Following the success of antiretroviral therapy for HIV, some researchers are now focusing their attention on a loftier goal — a cure. That means targeting viral reservoirs, primarily the long-lived cells of the immune system in which the virus lies dormant. Eliminating these reservoirs isn’t easy, but recent research offers glimmers of hope that it may one day be possible.

The strongest proof that HIV can be cured comes from the case of Timothy Brown, who was infected with HIV until he received a stem- cell transplant in 2007 to treat leukaemia1. He has remained free of HIV since then. Brown’s transplant helped cure his HIV, in part, because the donor's stem cells lacked a key receptor that the virus needs to enter cells.

But at this week's XIX International AIDS Conference in Washington DC, Timothy Henrich, an infectious-disease physician at the Brigham and Women’s Hospital in Boston, Massachusetts, reported a study of two HIV-infected men who received transplants of stem cells that did have the HIV receptor. Since they received a milder dose of chemotherapy than Brown prior to their transplants, they were able to continue taking antiretrovirals throughout the procedure. The transplants did not immediately eliminate the men’s infected immune cells, but roughly ten months later, the men had no evidence of HIV in their blood.

After their transplants, both men developed graft-versus-host disease, in which donor immune cells attack the transplant patient’s cells. Henrich and his colleagues speculate that the antiretroviral drugs protected the donor cells from infection with HIV. These healthy donor cells then destroyed the HIV-infected cells, leaving the men free of virus.

“Theoretically, they could be cured because the immune system was rebuilt under the coverage of antiviral therapy,” says Steven Deeks, an HIV researcher at the University of California, San Francisco, who wasn’t involved in the research. The ultimate test, however, will be to see whether the men remain HIV-free when they stop taking antiretroviral medicines. Henrich is working with the patients, their physicians and an ethics board to determine whether that is feasible.

126

Flushing out the virus But stem cell transplants are too risky to be used on people who don’t have a life-threatening illness. “This is not scalable or affordable or reasonable or ethical in anyone else,” Deeks says. A more palatable tactic would be to purge the virus from its main hiding spot — the long-lived memory cells of the immune system, called CD4+ memory T cells. A paper published this week inNature provides the first evidence that this may be possible in humans2 (see 'Drug brings HIV out of hiding'). David Margolis, an HIV expert at the University of North Carolina’s Center for Infectious Diseases in Chapel Hill, and his colleagues administered a cancer drug called vorinostat (suberoylanilide hydroxamic acid) to eight people in an attempt to coax dormant HIV out of hiding. A single dose of the medicine produced a 4.8-fold increase in HIV RNA expression. The hope is that this results in HIV particles being made and released, so that they are visible to the patient's immune system again. However, it is still unclear to scientists whether this increased expression will lead to the destruction of HIV-infected cells and shrink the viral reservoir. “But it's a positive signal,” says Nicolas Chomont, an HIV researcher at the Vaccine & Gene Therapy Institute of Florida in Port St Lucie.

But eliminating the viral reservoir might not be necessary to acheive something akin to a cure. In 2010, French researchers reported that they had identified a small group of patients who began antiretroviral therapy soon after HIV infection, then stopped taking the drugs after several years of treatment3. Since stopping treatment, these individuals have been able to control the virus naturally, for nearly seven years.

Unlike a group of HIV-infected patients known as elite controllers, who have specific genetic traits that enable them to control the virus, the group studied by the French team, known as the Visconti cohort, doesn’t seem to have a protective genetic component. At the Washington conference, Asier Sáez-Cirión, an HIV researcher at the Institut Pasteur in Paris, presented an in-depth look at the viral reservoirs of 11 people in this group. The virus seems to reside disproportionately in shorter- lived immune cells that die off faster, and Sáez-Cirión says that this may explain why the reservoir has shrunk over time in four of the patients.

How these patients are able to control the infection is not yet known. Early and prolonged treatment with antiretroviral therapy is key, but it doesn’t seem to work for everyone. Just 5–15% of those who receive early treatment for at least a year and then stop therapy are able to control their infection, Sáez-Cirión says.

“I think [these individuals] are fascinating,” Chomont says. “They have something that makes them able to control the virus.” The trick will be to identify what that is, he adds, and then find a way to reproduce it.

Although questions remain over how to tackle viral reservoirs, many HIV researchers are hopeful. “This is very similar to the dawn of the antiretroviral era in the mid-80s,” Deeks says. “Every time we turn around, there's something that we learn that opens up new avenues and makes people optimistic.”

Nature doi:10.1038/nature.2012.11077

http://www.nature.com/news/dormant-hiv-gets-rude-awakening-1.11077

127

New Scientist (UK)

HIV pioneers unite to stamp out the virus for good

12:33 25 July 2012 by Andy Coghlan

Could this be the endgame for HIV? Pioneers of HIV research last week announced a united goal: to stamp out the virus forever.

"Finding a cure is going to be one of multiple strategies to end the epidemic," says Sharon Lewin of the Alfred Hospital in Melbourne, Australia, who is one of the 34 founders of the global scientific strategy called "Towards an HIV Cure". The announcement came ahead of the 21st International AIDS Conference in Washington DC this week.

HIV can be suppressed using antiretroviral drugs but not cured, because the drugs only kill cells in which the virus is multiplying. HIV can lay low by inserting dormant copies of itself into the DNA of healthy cells. Lewin and others are researching new approaches to flush out HIV. She is managing a trial exploring a promising avenue – giving people a cancer drug called vorinostat that "wakes up the virus" so it can be destroyed with antiretroviral drugs.

Other avenues include loading immune cells with genes to sabotage a white-blood-cell's surface protein, CCR5, which HIV uses to enter cells. A treatment aimed at biochemically chipping the virus out of infected people's DNA is also in development. http://www.newscientist.com/article/dn22102-hiv-pioneers-unite-to-stamp-out-the-virus-for- good.html

128

NPR’s Boston Affiliate WBUR

Boston Doctors Say HIV No Longer Detectable In Two Patients

By Sacha Pfeiffer and Lynn Jolicoeur July 26, 2012

Sacha Pfeiffer: These two patients you’re studying had detectable levels of DNA from the HIV virus in their blood before having bone marrow transplants. The transplants took place two years ago for one of the patients and four years ago for the other. What happened with their HIV infections after that point?

Dr. Daniel Kuritzkes: As the transplanted cells took hold and killed off the patients’ own cells, which is the point of the transplant, we lost the ability to detect the HIV DNA in their cells. This is important because it’s the HIV DNA in cells that is really the reservoir of HIV, and why the virus persists even though anti-retroviral therapy is stopping it from reproducing.

And what was it that you think killed them off?

We expected that the donor cells would kill the host cells, but typically the donor cells become infected by HIV in the process of doing that. That’s because in most cases, the chemotherapy that patients get before the bone marrow transplant is so severe that it causes side effects that prevent patients from continuing their AIDS medicines. In the case of our patients, they got a milder form of chemotherapy and were able to continue their anti-retroviral therapy

129 throughout the entire transplant period. Therefore they were able to protect the uninfected donor cells from becoming infected. And that’s what’s so unique in this case.

But typically you may kill off the cancer, but the person remains HIV-positive after the treatment?

That’s exactly right.

After these transplants, your patients still tested positive for HIV in terms of antibodies, meaning their bodies still showed elevated levels of antibodies, indicating they’d been exposed to HIV. But I understand the antibody levels went down. Why is that significant?

The reason that’s significant is it tells us that there is little if any remaining HIV protein that could stimulate an antibody response.

So, considering all of that, do you consider this a cure of these two patients in terms of their HIV?

I think it’s really premature for us to talk about cure in these patients. We can’t say for certain that there isn’t HIV hiding somewhere in these patients that we don’t have access to. The only way to do that would be to stop therapy and to watch very carefully to see if any signs of HIV came back, and that’s something we can only do after we discuss this with the patients, their clinicians, and our Human Subjects Board to get approval to do that.

If transplants like the ones that your patients got are proved to be very beneficial in terms of eliminating HIV possibly, how realistic is it that these could be part of a standard step in a cure?

I don’t think bone marrow transplants are going to become a standard step towards a cure in the majority of HIV-infected patients because they’re risky and costly procedures to undergo. I do think, however, that this is an additional important step on the path towards finding a more practical cure, and it gives additional reason for optimism that we are on the right track.

Dr. Kuritzkes his fellow researchers also want to test the tissue of the patients to search for the presence of HIV. There is another man, from Seattle, considered “cured” of HIV after receiving a stem cell transplant in Germany. But there’s now a debate over whether some of his tissue samples show evidence of HIV, and that man’s treatment had some significant differences from the Boston patients’ treatment. http://www.wbur.org/2012/07/26/hiv-miracle

130

NPR’s “All Things Considered” & Shorts Blog

Two More Nearing AIDS 'Cure' After Bone Marrow Transplants, Doctors Say by RICHARD KNOX 07:50 pm, July 26, 2012

The so-called Berlin patient is famously the only person in the world who has been cured of HIV. But he may soon have company.

Two people in Boston also seem to be free of HIV after undergoing bone marrow transplants for cancer, just as the Berlin patient did five years ago. The crucial difference is that the Boston patients have not yet stopped taking anti-HIV drugs — although that may happen in the coming months. Harvard researchers got an enthusiastic response from an overflow crowd when they presented the first report on the patients at the 19th International AIDS Conference in Washington, D.C.

"As far as we've been able to measure, we can't find evidence of HIV infection in the patients' blood or blood plasma, and their antibody levels against HIV are dropping," Dr. Daniel Kuritzkes of Brigham and Women's Hospital told Shots. "The antibody evidence tells us there is little if any persisting HIV protein to trigger an anti-HIV response."

Kuritzkes is careful not to claim cure of HIV, although he says it's "entirely possible" that the two patients are cured.

"We can't say we've replicated the Berlin patient's cure at this point because our patients remain on antiretroviral therapy," Kuritzkes says. Only if they stop therapy for months and years, without seeing a rebound of HIV in their blood, can these new bone marrow transplant patients be declared cured.

Meanwhile the Boston patients are shedding light on just what may have cured Timothy Ray Brown, the Berlin patient. He's an American HIV patient from Seattle who had two bone marrow transplants for leukemia while he was living in Berlin more than five years ago. Brown has been free of daily antiviral drugs ever since with no reappearance of the virus. Thus, he's considered "functionally" cured, even if traces of HIV genes may persist in some of his cells. (That's a matter of some uncertainty.)

It's been widely assumed that the magic in Brown's cure resides in the stem cells he got from a bone marrow donor. Those donor cells lack a receptor called CCR5 that HIV uses to enter immune cells. Not necessarily, the Boston researchers say. The donor cells their patients got did notlack the receptor. So what's happening with them must be different from the Berlin patient.

131 The Boston researchers think their might-be-cures are due to two factors:

The patients got a milder form of pre-transplant chemotherapy. As a result, they were able to stay on their anti-HIV drugs. That protected the transplanted donor cells from becoming infected with any HIV that might have been hiding out in their bodies.

The donor cells most likely killed off the patients' own HIV-infected immune cells as the bone marrow transplants took effect.

This second phenomenon is called graft-versus-host disease. The donor cells see the patients' native cells as foreigners and attack them.

"The success of a bone marrow transplant depends on having the right amount of graft-versus-host disease," Kuritzkes says. "You need a little bit. You hope not to have so much that you get clinically sick from it."

The Berlin patient also had episodes of graft-versus-host disease. That could help explain why his HIV infection was extinguished — or driven to such low levels that his new immune system is able to control it.

It's possible that the lack of CCR5 receptors on the donor cells did contribute to the Berlin patient's cure. But scientists are excited by the possibility that a cure may notrequire donor cells lacking CCR5 receptors. That would widen the donor pool, since very few people are lucky enough to lack CCR5.

Another small step on the road to a cure comes in a report by David Margolis of the University of North Carolina published this week in Nature. He writes that a cancer drug called vorinostat can smoke HIV out of its hidden reservoirs. Researchers are wondering whether they could combine this with a way of killing the virus before it can start a new cycle of infection — a strategy called "shock and kill."

Dr. Steven Deeks of the University of California San Francisco warns not to expect that the road to a cure will be a quick dash. "I would be shocked," he said at a press conference, if scientists designed a workable cure within the next decade. "But it's at least possible, and we all think it's worth pursuing." http://www.npr.org/blogs/health/2012/07/26/157444649/two-more-nearing-aids-cure-after- bone-marrow-transplants-doctors-say

132

South African Broadcasting Corporation

Scientists Making Progress In Finding Hiv Cure

Friday 27 July 2012 06:40 Thabile Maphanga

HIV/Aids scientists say various studies presented at the International Aids conference in Washington have given them a strong lead on how to fight the disease. They've presented results of at least four scientific studies where the virus could not be detected in patients at the end of each study.

The studies have been presented under the theme "Finding an HIV cure". A study at the Harvard Medical School involved doing a bone marrow transplant on two patients while they were on antiretroviral treatment. The study was led by the school's Chief of Infectious Diseases, Professor Daniel Kuritz-kes.

Kuritz-kes says the patients are still on their treatment and are being encouraged to stay on their treatment because there isn’t evidence that they’ve actually being cured.

“We think all we've done is show that it's possible to protect donor cells from becoming infected by continuing antiretroviral therapy to stop the new cells from getting HIV infection. Later experiments that we are planning now will tell us for sure whether these patients can stop their antiretroviral therapy or not,” says Kuritz-kes.

Meanwhile the Executive Director of the Joint United Programme on HIV/Aids Michel Sidibé, said he believes a cure for Aids will be found within 10 years. Sidibé said the current research studies have shown great progress in finding a possible cure for this disease.

He said there is a need for further investments in HIV research. “ We are seeing progress, what we need is to mobilise science, we need to continue to invest in research because without the cure, I don't think we'll eradicate, we can end but not eradicate this epidemic, we need cure or vaccine. How far are we? I personally feel that cure is not so far, functional cure is possible probably in the six to 10 years.”

Sidibé added there is a need for further investments in HIV research.

http://www.sabc.co.za/news/a/99238c004c1ffebe86b0af8b30ab6902/Scientists-making- progress-in-finding-HIV-cure-20122707

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Wall Street Journal’s “Health Blog”

New Urgency, Momentum in Search for AIDS Cure

By Betsy McKay July 27, 2012, 3:18 PM

At the XIX International AIDS Conferencein Washington this week, public-health leaders and scientists explored potential ways to finally cure the disease — as urgently as possible. “A cure for AIDS could be found in 10 years,” Michel Sidibé, chief of the Joint United Nations Program on HIV/AIDS, or UNAIDS, tells the Health Blog.

The newfound enthusiasm for cure research, as WSJ explained last week, stems from the successful cure of one patient and some other nascent but promising breakthroughs.

“It’s no longer the ‘c-word,’” says Steven Deeks, a researcher at the University of California San Francisco who co-led the development of a global scientific strategy for AIDS-cure research released here last week. “There’s a consensus that this is an important question to tackle.” As to when a cure might be found, ten years is possible, he says, though it will “probably” take longer.

The search for a cure was a prominent theme at this week’s conference, with the one man who has been cured of AIDS — Timothy Brown, aka the “Berlin patient” — making an appearance nearby to announce the launch of a new effort in the fight against AIDS.

And studies released this week shows how the march toward a cure is advancing. In one presented Thursday, a group of patients with HIV who had been treated early showed no sign of resurgence in their infection once they were taken off lifesaving antiretroviral drugs. ARVs suppress the HIV virus, but it normally resurges once drug therapy is

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Six years after halting drug treatment, the patients have an extremely low “reservoir” of HIV virus in their cells and are able to control their infection. “These results suggest that the antiretroviral treatment should be started very early after infection,” lead researcher Charline Bacchus said in a statement on the work done at the French National Agency for Research on AIDS and Viral Hepatitis.

In another study by Daniel Kuritzkes of Brigham and Women’s Hospital and Harvard Medical School, two HIV-infected men underwent stem-cell transplants for treatment of lymphoma. Both men had been on ARV-drug treatment for years and their virus was suppressed. HIV was detectable in their cells immediately after transplant, but wasn’t several months later. It’s unclear whether the fact that they had remained on their antiretroviral medication played a role in that.

In yet another study, a team led by David Margolis of the University of North Carolina at Chapel Hill, unmasked HIV virus that had been suppressed and was hiding in the bodies of eight HIV-infected men using a drug normally used to treat lymphoma. The idea of such research is to activate a latent virus, then find a way to eliminate it. The results were published Wednesday in Nature. Dr. Margolis initially presented the work at a conference in March, showing results in six infected men. No cure to AIDS is right around the corner, UCSF’S Dr. Deeks cautions. Still, scientists at the conference expect such research to play an increasingly visible role at AIDS conferences. “We’re being encouraged to pursue this,” he says. http://blogs.wsj.com/health/2012/07/27/new-urgency-momentum-in-search-for-aids-cure/

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WebMD

AIDS Cure Possible, Top Scientists Say

HIV/AIDS Experts Launch International Push for AIDS Cure

By Daniel J. DeNoon WebMD Health News

July 20, 2012 -- An AIDS cure is possible, top HIV/AIDS researchers now say.

It's a stunning turnaround. Hopes for an AIDS cure were dashed early in the epidemic when researchers realized that the AIDS virus can lurk inside dormant cells to avoid elimination by powerful anti-HIV drugs.

"Today we have new information that makes us think an HIV cure should be possible," HIV co- discoverer Francoise Barre-Sinoussi, PhD, tells WebMD.

Barre-Sinoussi and other leading AIDS researchers today open a two-day conference, "Towards an AIDS Cure," in advance of next week's International AIDS Conference in Washington, D.C. It's the most optimistic opening of an AIDS conference since the discovery that a combination of HIV drugs could keep a person from developing AIDS.

Now these researchers want to go a step further. They believe it's possible to totally eradicate HIV from the body -- or, failing that, to achieve a "functional cure" that will keep a person AIDS-free without the need for HIV drugs despite lingering HIV in the body.

Barre-Sinoussi is president-elect of the International AIDS Society, sponsor of the International AIDS Conferences, and the major partner in the new AIDS cure alliance.

Co-led by Barre-Sinoussi and Steven G. Deeks, MD, of the University of California, San Francisco, a group of 34 top AIDS researchers and clinicians has laid out a global scientific strategy for curing AIDS.

This strategy stresses six key steps that must be taken:

 Establish large, multinational collaborations between experts in a wide range of fields.  Basic scientists should work side by side with clinicians, quickly translating what's learned in the lab into human studies and translating what's learned in human studies back to the lab.

136  Finding the best animal models for exploring an AIDS cure. For example, researchers have recently learned to model treatment with human anti-HIV drugs in macaque monkeys infected with SIV, the simian version of HIV.  Mentor and support young researchers with new ideas.  Address difficult regulatory issues surrounding drug testing. AIDS cure research will need to test new drugs -- some with a high likelihood of toxicity -- in HIV-infected patients who are doing well on their current drug regimens.  Get strong community support by ensuring that patients and the communities are fully informed about the risks and benefits of cure research.

There are seven priorities for this research:

 Figure out exactly how HIV persists in the body despite effective anti-HIV treatment.  Figure out exactly where in the body HIV is hiding.  Figure out why the immune systems of people being treated with anti-HIV drugs are activated, and what this means for HIV persistence.  Figure out the immune mechanisms in "elite controllers" that control HIV infection but allow it to persist.  Develop tests to measure persistent HIV infection.  Develop and test strategies to eliminate latent HIV infection.  Develop and test strategies to enhance the ability of the immune system to control HIV infection.

It's not a pipe dream. Eleven HIV cure clinical trials already are under way. Three others are starting soon.

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