Commentary & Opinion
New HIV/AIDS Research Directions Show Promise, NEJM Editorial Says
February 12, 2009
Some recent HIV/AIDS research that examines the role certain genes play in inhibiting HIV progression shows promise for the development of new treatment measures, Jay Levy of the University of California-San Francisco writes in an editorial published Thursday in the New England Journal of Medicine. According to Levy, research has identified certain HIV-positive people who do not take antiretroviral drugs and still do not progress to AIDS for more than 10 years. In addition, some people remain HIV-negative even after repeated exposure to the virus, he writes. According to Levy, these "long-term survivors and those who have been exposed to HIV but remain seronegative offer a great opportunity to study the mechanisms of resistance to HIV infection and disease."
Despite the promising results of the Hutter study, several challenges remain for developing effective HIV treatments based on the research, Levy writes, adding that an "X4 type of HIV ... could eventually emerge" because this "virus grows in cells lacking CCR5 expression." In addition, "people lacking the CCR5 gene can be more susceptible to serious effects from certain infections," according to Levy. He continues that "many patients die" from bone marrow transplants and administering manipulated stem cells "carries a similar risk." Therefore, "an approach designed to modify HIV target cells without eliminating the host's own bone marrow could be helpful," he writes. According to Levy, one example would be to inject an HIV-positive person with a biochemical compound or genetic vector that inactivates the CCR5 gene. He writes, "Although such techniques need to be perfected, they point in directions that may serve as stimuli for other innovative gene therapies" to treat HIV-positive people. Levy writes that the case described in Hutter's study "places further emphasis on gene therapies and treatments directed at blocking the CCR5 receptor," concluding that the study "could pave the way for innovative approaches that provide long-lasting viral control with limited toxicities for persons with HIV" (Levy, NEJM, 2/12).
The editorial is available online. The Hutter study also is available online.
This article was provided by Henry J. Kaiser Family Foundation. It is a part of the publication Kaiser Daily HIV/AIDS Report. Visit the Kaiser Family Foundation's website to find out more about their activities, publications and services.