HIV cells reawaken with "shock-and-kill" approach

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A new study has found that a newly discovered kind of drug can reawaken remnants of HIV cells that are hiding in the body.

Researchers at the Sanford Burnham Prebys Medical Discovery Institute (SBP) are on to a new way of getting rid of HIV once and for all: shock and kill them. According to Medical Xpress the process involves reawakening latent HIV cells in the body and then killing it with a drug. The findings are published in the journal Cell Host & Microbe.

There is no known cure for HIV but infected people live through the years through antiretroviral drugs (ARVs) to manage and stop the progression of the disease. But with these therapies, HIV patients have cells that make the virus undetectable for many years by the body's immune system.

When the patient stops taking the antiretroviral drugs, the latent HIV cells reawaken again and destroy the body's ability to fight infections. The best way to treat HIV is to lure these infected cells by reawakening them and killing them once and for all.

"If you take people off their antiretroviral therapies, some of these dormant cells reawaken to make more virus and re-establish disease, said Dr. Lars Pache, lead author from SBP.  "The key for a cure for HIV is to purge these cells that have dormant HIV."

For the study, the researchers used the shock-and-kill approach by using Smac mimetics. These drugs "tap into a molecular backdoor, a cell pathway that can be used as an intense alarm to wake up the virus, but doesn't appear to activate the immune system," said Dr. Sumit Chanda, co-author of the study from the SBP.

When the latent virus is reactivated, it is hoped that the immune system will attack the infected cells and kill them.

However, the team is wondering if the dormant HIV cells in patients can be activated if they are on antiretroviral drugs.

"We anticipated that we would see a synergy because the drugs work along parallel pathways. What we didn't expect was the level of activation and the efficacy with which we were able to reverse latency in patient samples," Chanda said.

The Smac mimetics looks to be promising and they are also safe for cancer trial treatments.

"Although there are clinical- stage Smac mimetics available, they were not specifically developed for HIV-1 treatment. Our internal drug possesses about 10-100 times more potent LRA activity than the small molecules currently in clinical development, making it a promising next-generation candidate to tackle HIV latency," Chanda explained.

The scientists concluded that a combination of drugs may be used to completely eradicate HIV in addition to Smac mimetics. They are hoping to find a pharmaceutical partner to help further these findings to human trials.