In Discussing a Cure for HIV, Researchers Say the Time is Now

Despite the success of antiretroviral drug therapy, more people contract HIV every day than initiate treatment. Even if clinicians administered antiretrovirals to each infected individual – an unattainable task, especially in the developing world – they still couldn’t eradicate the disease, as much of the virus remains hidden in latent pools within the body.

Given those obstacles, curing HIV might sound impossible, but not so for the dozens of guests that attended a June 27, dinner  hosted by the Collaboratory of AIDS Researchers for Eradication. or CARE. The event was buzzing with enthusiasm as people from the NIH, academia and industry discussed the progress that CARE has already made toward that lofty goal.

CARE is an undertaking based at UNC that brings together over 20 investigators from 11 different institutions with the unifying goal of curing the deadly illness. It focuses specifically on discovering novel drug therapies that will disrupt the latent HIV viral reservoir and lead to eradication. The Collaboratory is part of the larger UNC HIV/AIDS Enterprise, includes over 400 researchers working to prevent, treat and cure HIV infection and AIDS.

“The great thing about working at UNC is that all the expertise you need is right here. We have Myron Cohen, David Margolis, Charles van der Horst, and many others; it’s very exciting,” said J. Victor Garcia-Martinez, Ph.D., who came to UNC faculty in 2009 to join the university’s search for a cure. Garcia-Martinez and his fellow members of CARE recently found that breast milk kills HIV and blocks its oral transmission in a humanized mouse model, pointing the way toward natural products that may one day be used to combat the virus.

One of the guest speakers at the dinner, Carl W. Dieffenbach, Ph.D., explained that UNC’s groundbreaking research on treatment as prevention galvanized Secretary of State Hilary Clinton to talk about the “beginning of the end of AIDS.”

“Treatment as prevention can now be the cornerstone of a two-pronged approach to get a handle on this epidemic,” said Dieffenbach, director of the division of AIDS of the National Institute of Allergy and Infectious Diseases (NIAID), which funds the CARE Collaboratory. “But if we want to get rid of it for good, we are going to need to find a cure.”

Dieffenbach said he had heard a biotech researcher complain that it could take 30 years to translate a discovery into a new drug. By that measure, HIV researchers have been “spoiled,” Dieffenbach stated, referencing the fact that the crystallization of protease occurred in 1989 and the first protease inhibitors were approved just six years later. Following the history a bit further, he noted that the virus was shown to persist in treated patients back in 1997, saying that it was indeed time for the CARE researchers to capitalize on that discovery.

One of the latest recruits to that endeavor is Jeffrey S. Stringer, MD, professor of obstetrics and gynecology, division of global women’s health at UNC. Stringer, the second guest speaker of the night, asked for the audience’s patience as he was “ten days off the boat” from Africa, where he directs the Center for Infectious Disease Research in Zambia (CIDRZ). Stringer is also Principle Investigator of the center’s NIH-funded HIV/AIDS Clinical Trials Unit, which conducts clinical trials in HIV prevention, antiretroviral therapy, pediatric and maternal HIV, and prevention of HIV with microbicides. He explained that many of the patients CIDRZ starts on treatment do not return to continue their care, underscoring the need for efforts that go beyond suppression to complete eradication of the disease.

Stringer brought a handful of faculty with him to UNC from his previous position at the University of Alabama, all of them ready to share their expertise in field work and implementation with the CARE project. He said he often hears the misconception that HIV is fixed, and that clinicians should move on to other public health problems like opportunistic infections, nutrition and maternal mortality. Stringer disagrees.

“We need to fight to keep the resources flowing, to keep our eye on the ball, which is to eradicate this disease,” he said. “Our job is not finished yet. Just because we have a lot of people on treatment in developing countries doesn’t mean we’ve won.”