Immunotherapy and HIV.
Scientists have made significant progress with a special kind of HIV vaccine. The goal: allow HIV patients to halt daily dose ARVs. ‘Immunotherapy’ is engineered to target HIV and activate specific T helper cells.
What is immunotherapy and how does it work?
Immunotherapy and vaccines
Scientists have made significant progress with a special kind of HIV vaccine. The goal: allow HIV patients to halt daily dose ARVs. ‘Immunotherapy’ is engineered to target HIV and activate specific T helper cells. This effectively kicks the virus out of hiding, then kills it. The key to this treatment is the way that immune cells are engineered to work together.
The study focused on using blood samples from HIV patients. Although yet to undergo clinical trials, thus far the results have been astonishing. If all trials succeed, HIV treatment plans will never be the same.
“A lot of scientists are trying to develop a cure for HIV,” said senior author Robbie Mailliard, Ph.D., assistant professor of infectious diseases and microbiology at Pitt Public Health. “It’s usually built around the ‘kick and kill’ concept; kick the virus out of hiding and then kill it. There are some promising therapies being developed for the kill, but the Holy Grail is figuring out which cells are harbouring HIV so we know what to kick.”
The danger of halting treatment plans
Deviating from treatment plans exposes you to higher risk than you realise. You create a lapse in the routine timing of chemical reactions designed to keep your viral load down, and you expose yourself to risks of viral relapse. The side effects can be far more serious in a relapse, without medical supervision. Worse yet: it can evolve into full-blown AIDS.
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How did they do it?
Your immune system copes with a lot all at once. Part of its mission is to keep something called CMV in check. Some patients have a one in five ratio of cells specific to any one particular virus. “That got us thinking – maybe those cells that are specific to fighting CMV also make up a large part of the latent HIV reservoir. So we engineered our immunotherapy to not only target HIV but to also activate CMV-specific T helper cells.”
“You have to collect a lot of blood to find T cells latently infected with functional HIV in people on ART – it could be as few as 1 out of every 10 million cells.” In addition to the T helper cells, dendritic immune cells were also isolated for their ‘delegation’ abilities toward other immune cells. Conventional dendritic cells also have been used to induce the immune system to kill HIV. When the MDC1 was added back to T helper cells containing latent HIV, they reversed that latency as expected, kicking the virus out of hiding. And then the big test came.
“Without adding any other drug or therapy, MDC1 was then able to recruit killer T cells to eliminate the virally infected cells. With just MDC1, we achieved both kick and kill – it’s like the Swiss Army knife of immunotherapies. To our knowledge, this is the first study to programme dendritic cells to incorporate CMV to get the kick, and also to get the kill.”
The team is now pursuing funding to begin clinical trials to test this property of MDC1 in humans.
Houser, K. 2019. First of its kind HIV therapy draws out the virus, then kills it. Futurism. 5 April. Available at: https://futurism.com/the-byte/hiv-immunotherapy-draws-cells-kills-them [Accessed 30 July 2019].
University of Pittsburgh Graduate School of Public Health. 2019. Immunotherapy Kicks, Kills HIV by Exploiting a Common Virus. [Press Release]. 3 April. Available online at: https://www.upmc.com/media/news/040319-kristoff-mailliard-mdc1 [Accessed 30 July 2019].
We all have questions.
Below are some of the answers to the most common questions around HIV.
What is usually the first sign of HIV?
After becoming infected with HIV, most patients only experience moderate flu-like symptoms. Typically, the illness is sudden in onset and is characterised by fever, swelling of the lymph glands, a measles-like rash all over the body, ulcers in the mouth and sometimes on the genitalia.
What are the 4 stages of HIV?
- Stage 1: Infection – Exposure to infected bodily fluids.
- Stage 2: Asymptomatic – HIV quickly spreads and the patient becomes seropositive for HIV antibodies.
- Stage 3: Symptomatic – The immune system is now engaged in a constant battle with the rapidly replicating virus.
- Stage 4: AIDS – At this stage, the patient’s CD4+ count is 200 cells per mm3 or less.
How soon can HIV be detected by a blood test?
No test can detect HIV immediately after infection. The time between initial infection and a detectable viral load is called the window period. It can take anywhere from 2-12 weeks to after exposure, to detect whether you are HIV-positive or not, depending on which testing method is used.
How long does it take to show symptoms of HIV?
Following initial infection, there is a period of intense, unchecked viral replication that occurs. It usually takes 2 to 4 weeks after infection and can last about 1 to 2 weeks, after which there tends to be a slight recovery, and the infected individual is considered to be seropositive for HIV antibodies.
How is HIV transmitted?
HIV is transmitted from one person to another through the exchange of body fluids. The main method of transmission in South Africa is through unprotected sexual activity.
Does HIV test affect life insurance?
Being HIV-positive can affect standard life insurance policies, particularly if your status changes from HIV-negative to HIV-positive within a particular age range. That’s why AllLife covers all lives. Your HIV status doesn’t prevent you from getting cover with us.
Can HIV-positive women have children?
Yes, HIV-positive women can enjoy healthy pregnancies and give birth to healthy HIV-negative babies, through the Prevention of Mother to Child Transmission (PMTCT) programme. PMTCT has been highly effective in reducing the HIV transmission risk to under 1%.
How can the spread of HIV be prevented?
How to take the relevant precautions and prevent transmission against the HIV virus.
Managing your ARVs
When to start Antiretroviral treatment and the reasons behind why you should not delay treatment.
The effects of HIV on the immune system
Understand the effects HIV has on the immune system and when drug therapy is necessary.