An Oregon Health and Science University (OHSU) HIV researcher and his team have found the hiding place where the HIV virus shields itself from an assault by the body’s immune system – another step toward finding a cure to the disease.
Dr. Louis Picker and his team say the next step is creating a strategy to breach the hiding place.
“The first thing we need to do in a cure is figure out what the barriers are,” Picker said.“You peel back the onion until you get a good map of your enemy.”
Picker is one of the top researchers worldwide working on a vaccine against HIV, the virus that causes AIDS. In 2013, his team declared they had developed a vaccine that immunized monkeys. Today, five years later, the monkeys are still virus free.
“They’re cured,” Picker said.
The research published on Monday in the journal Nature Medicine marks a new phase: trying to figure out how to kill the virus once someone is infected. This task is more difficult than devising a preventative vaccine.
“It’s going to be a much bigger deal,” Picker said. “It’s 100,000-fold bigger.” A drug that eliminates HIV after infection could cure the 35 million people around the world with HIV.
In 2013 alone, 1.5 million died of AIDS, according to the World Health Organization.
The monkeys tested were infected with simian immunodeficiency virus, SIV, then treated with anti-retroviral therapy (ART). ART essentially freezes the virus, preventing it from infecting new cells. It does not destroy the virus, however, which is why patients have to remain on ART for the rest of their lives.
Picker’s team discovered that the virus found sanctuary in B cell follicles, which are lodged in lymph nodes. B cell follicles cannot be breached by T cells, the elite troops of the immune system.
“If a pathogen can get into a B cell follicle, it’s going to be shielded from the killer T cell response,” Picker said. “Imagine they’re in the church, so to speak, and the soldiers can’t get in.”
A successful cure would first have to penetrate the barrier, allowing the vaccine to fight the virus. The barrier itself does not discourage Picker.
“What’s more discouraging is if you don’t know about these things and you try something and it doesn’t work,” Picker said.“If you figure out beforehand that this is a barrier before you get your hopes up, you figure a way around this.”
Picker believes such a work-around is entirely doable.
“It sounds pretty radical but it happens every day in cancer therapy,” Picker said. “I think we can come up with a more subtle treatment than that.”
Picker estimates a cure surmounting these barriers can be found in three or four years.