Transcript HIV Cure - International AIDS Society

The Future of HIV/AIDS:
The Road to a Cure
How HIV persists during therapy?
Viral replication
T cell survival
Proliferation
Courtesy of Nicholas Chomont
 Ongoing viral replication occurs in subjects on suppressive HAART (TW Chun, JCI;
N Tobin, J Virol 2005).
 HIV integrate in long lived resting memory T cells and persist despite suppressive
HAART (TW Chun, Nat. Med 1995, D Finzi, Science ; TW Chun, PNAS 1997).
 Reservoir cells, like other memory T cells, divide very slowly to maintain the
memory of the immune system (A. Bosque and V. Planelles)
What is our goal?
Eradication vs Remission
What strategies to control/eradicate
reservoirs? 1/2
 Intensification of HAART (+/- other interventions)
 Early initiation of HAART (limit viral reservoirs)
 Improved Drugs (penetrating anatomical compartments)
 Reactivation of HIV replication from latent reservoirs:
 ”Shock and Kill”
Cytokines, chemical
compounds…
Uninfected cells
HIV-induced cell death
Courtesy of Nicholas Chomont
What strategies to control/eradicate
reservoirs? 2/2
 Interfering with immunological mechanism that contribute to HIV
persistence
 Other therapeutic interventions (Gene/Mol therapy, therapeutic
vaccine)
T cell survival
Courtesy of Nicholas Chomont
Antibodies, cytokines, gene
therapy, chemotherapy
Proliferation
While we are searching:
 Keep patients ready by:
Universal Access
Inspired from Sharon Lewin
Early Treatment - Limit reservoirs and preserve the immune system
 Invest in research:
 Better understanding of biological mechanism and role of the
immune system in establishing reservoirs and persistence
 Better tools and models
 In vitro and in vivo models
 More precise assays and sensitive techniques
Drug development: increased specificity for latently infected cells
 Develop translational research
Global Scientific Strategy
Towards an HIV Cure
While the Global Fund keeps working towards Universal Access:
 IAS to coordinate and support the creation of an international
multidisciplinary scientific advisory group on HIV Reservoirs to
develop a Global Scientific Strategy « Towards an HIV Cure »
 A Global Scientific Consortium « Towards an (functional) HIV
Cure » ?
Acknowledgements
International AIDS Society, Geneva:
•Shirin Heidari
•Marie-Capucine Penicaud
•Tamara Torri
•Julie Pluies
•Anthony Flynn
With courtesy of members of IAS Core
Group Towards An HIV Cure who shared
their slides:
􀁹 Nicolas Chomont, Vaccine and Gene
Therapy Institute Florida, USA
􀁹 Tae-Wook Chun, National Institutes of
Health, USA
􀁹 Sharon Lewin, Burnet Institute,
Melbourne, Australia