July 2, 2007
Current HIV drugs target either viral enzymes -- biologically important proteins -- or interfere with HIV's entry in to a cell. This strategy has been remarkably successful at managing HIV disease and drastically reducing both illness and HIV-related deaths. The essential limitation of this approach lies in HIV's integration of its genetic code into a cell's own genes. When this happens in a cell that is at a resting state, it allows HIV to evade these drugs, which only work in cells that are active and producing new copies of HIV. Because resting cells are long lived and serve as an untouchable reservoir of infectious virus, efforts to rid the body of HIV -- called eradication -- have been unsuccessful.
The work, led by Indrani Sarkar at the Max Plank Institute for Molecular and Cell Biology, may hold the key to solving this problem. Using an enzyme that has been studied extensively in genetic research, scientists were able to locate and extract certain HIV genes from infected cells. The enzyme, called Tre, is able to recognize the integrated HIV genes -- called proviral DNA -- because it leaves certain, identifiable makers where it has been spliced in to the cell's genes.
Much more research and development will need to be done to turn this discovery into an effective treatment for people living with HIV. One of the key hurdles will be to find a safe and effective way to introduce the enzyme into resting cells. Another step will be designing similar enzymes that target other parts of the HIV genome. It is likely to be ten or more years before this finding could be turned in to a widely available therapy. Nonetheless, this 'proof of concept' study may point the way forward toward the ultimate goal of curing HIV infection.
While many have grown skeptical of the possibility of curing HIV/AIDS, Project Inform remains firmly dedicated to this goal. The transformation of HIV/AIDS from an almost universally fatal disease to a somewhat chronically manageable disease has been great progress. However, it is not enough. Life-long, expensive multi-drug treatment is simply not good enough. The burdens it puts on people with HIV and various health systems are just too great. Factoring in the vast majority of people living with HIV who cannot access the life-saving drugs we have now makes the need for a cure that much more evident. We will watch this research, along with all cure-based science, with extra care.