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to Section One | to Arts & Entertainment
posted Friday, July 25 2014 - Volume 42 Issue 30
Anti-cancer drug may flush out HIV, study says
Section One
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Anti-cancer drug may flush out HIV, study says

by Mike Andrew - SGN Staff Writer

The anti-cancer drug romidepsin may flush out hidden reservoirs of HIV so the virus can be killed by antiretrovirals, according to a new Danish study reported at this year's International AIDS Conference.

'It's called the kick and kill approach,' said Dr. Ole Schmeltz Sogaard from Aarhus University in Denmark.

Romidepsin is usually used to treat lymphoma, but Sogaard and his team tested it on six HIV-positive patients in April.

The test subjects all had undetectable levels of HIV, indicating the disease had been controlled by medications. Each of the six then received a reduced dose of romidepsin once a week for three weeks.

This resulted in a noticeable jump in viral levels in the blood in five of the six patients, showing that they had hidden reservoirs of the virus that were not detectable. The researchers also found the drug increased the virus production in HIV-infected cells between two and almost four times above normal.

Romidepsin works by 'relaxing' tight coiled up bundles of DNA. This exposes the hidden HIV genetic code and leads to the production of new viruses.

'We have now shown that we can activate a hibernating virus with romidepsin and that the activated virus moves into the bloodstream in large amounts,' Sogaard said.

'The trial now moves into a new phase which combines the romidepsin with something to enhance the immune system and in our case this is an HIV vaccine.'

Another recent study published in the journal Nature showed that aggressive early treatment of HIV may not be as effective as once hoped because the virus forms hidden reservoirs much earlier than previously thought, even before HIV antibodies are detectable in a patient's blood. If romidepsin could be used to flush out those reservoirs, then antiretroviral treatments might be able to affect a practical 'cure' for HIV.

Sogaard cautioned that there are still challenges ahead for his research.

'This is a step in the right direction, but there is still a long way to go and many obstacles to overcome before we can start talking about a cure against HIV,' he said.

For example, the research team could not determine what proportion of cells hiding HIV are being activated by romidepsin, or which HIV reservoirs are being successfully targeted. HIV can hide in immune cells in the blood, but there are bigger reservoirs in the gut and central nervous systems and it is not clear whether they are activated by the blood-based chemotherapy.

'We know it's a step forwards, but we don't know how big; it might just be a single step or it could be a great leap forward,' Sogaard added.

'As a proof of concept it does look promising,' according to Dr. Andrew Freedman of Cardiff University in Wales. 'The search for a cure is very much on, it's not going to be easy and it's unlikely a single drug like this would be sufficient.

'There's a lot of doubt it would be enough to deplete the reservoir completely. Most people think a single approach will not be enough; a drug like this perhaps needs to be combined with vaccines or even gene-therapy.'

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