Winners: Who HAS doubled the budget of the NIH?

The National Institutes of Health has been flat funded since 2003, and due to high biomedical inflation, the lack of money is eating into major research opportunities for major diseases, a fact that has somehow escaped the attention of the American people.

Love him or not, former Representative Newt (short for Newton) Gingrich helped double the size of the National Institutes of Health when he was Speaker of the House of Representatives. We at the AIDS Policy Project always like to identify who actually did what. 

Vienna Cure Report from Project Inform

One of the standing-room-only sessions on HIV cure research at the Vienna AIDS Conference. There were also dozens of people watching the session on a closed-circuit TV set up outside the door. Photo Credit: AIDS Policy Project

We are inviting a few guest bloggers who are also interested in AIDS cure research to post on our Cure Blog. Matt Sharp, a longtime AIDS activist, is the first. --Kate Krauss, AIDS Policy Project

The road to a cure for HIV, by Matt Sharp

There continues to be excitement and buzz especially in the research community regarding more understanding of the pathway to a cure for HIV. Recently, an NIH collaborative grant for cure research named in honor of Martin Delaney was announced that will provide even more federal dollars to the effort—though not enough. Advocates are scaling up their knowledge and working with the important players to lead to the most direct research path to a cure. There was an exciting workshop before the Vienna conference entitled: Towards a Cure: HIV Reservoirs and Strategies to Control Them. And while the efforts are moving in the right direction, there is a way to go to unlocking critical basic scientific and practical questions that scientists have long pondered, such as: Why there is residual virus and how is it causing long-term inflammation that eventually leads to the cause of most mortality seen in AIDS today? What are the biological keys to unlocking these problems? How can scientists work better together in a focused effort for a cure? How will studies ethically allow for cure research in people who are doing well?

Sharon Lewin from Monash University in Melbourne, Australia gave a succinct and motivating opening plenary speech stating that even treating the current 40% of HIV-positive people in low- and middle-income countries starting at the CD4 threshold of 200 cells would cost $25 billion by 2030, while increasing coverage to 80% would raise that cost to $35 billion. We cannot treat ourselves out of the epidemic as current cost projections and universal access and sustainability are improbable. She said that “while there won’t be a cure announced in Vienna, it will mark the future where we seriously prioritize finding a cure”.

Finding a cure is the new wave of HIV research and knowledge in this area is growing at every HIV meeting. Pharmaceutical companies have teams of scientists focusing on new drug targets and are screening millions of candidates that will flush HIV out of cells. Some two dozen HDAC inhibitors (histone deacetylase) are being studied to activate latent virus for these cells. Some of these compounds are also being studied in cancer. IL-7 can also activate cells and is moving forward in Phase 2 clinical studies. This is one area of eradication research that is moving ahead that many are not aware is happening.

Lessons are being learned from the Berlin “cure” patient who received a bone marrow transplant for lymphoma using HIV resistant cells. He remains free of HIV today. Several cell therapy strategies rendering HIV resistant by genetic manipulation are already in clinical studies.

Project Inform's full Vienna report is here.

What's all this about neutralizing antibodies against AIDS?

Dr. Paul Sax

There is a new video explaining the whole new "anti-HIV antibodies" discovery.

Check out Dr. Paul Sax from Brigham and Women's Hospital in Boston as he very clearly explains, in a four-minute video, all the excitement over the new research published in Science regarding HIV-neutralizing antibodies. (Science seems to be on a roll.) Researchers have discovered a man whose anti-AIDS antibodies actually kill AIDS! Unlike almost everyone else's. It's an understandingly perky and enthusiastic Paul Sax, on video in what appears to be his living room.

Thanks, Paul--super clear and helpful!

http://www.medscape.com/viewarticle/725376?src=emailthis

An AIDS Patient Quits his Drugs

Dr. Tae-Wook Chun, from NIAID, in Vienna, 2010

One Patient's Story Illuminates a Whole Situation: 
Information and Commentary

Tae-Wook Chun,  a researcher at the National Institutes of Health's National Institute of Allergy and Infectious Diseases, gave a fascinating talk at the Vienna HIV reservoirs workshop. He had a patient who had been HIV+ for almost ten years, was being treated using HAART (Highly Active Anti-Retroviral Therapy) and had the lowest viral load ever recorded in Dr. Chun's lab. The patient had rarely ever even had a viral blip (a shortlived increase in viral load). Chun was using special tests to monitor the patient's viral load that are much more sensitive than the viral load tests many people with AIDS receive in their doctors' offices. Even with these sensitive tests, this patient's viral load was tiny, tiny.  The patient had been treated aggressively and early in his HIV infection ten years before.

A lab, a plant, a compound ten times more powerful than prostratin?

The Man: José Alcami

The Plant: Euphorbia (one of many types of Euphorbia)

Interview with José Alcami, from the the Instituto de Salud Carlos III in Madrid

Interview conducted on July 17, 2010 at the "Toward a Cure" HIV Reservoirs Workshop, Vienna, Austria

AIDS Policy Project: Thanks so much for sitting down with us. Tell us about your work.

I work in Spain in a basic research lab*. We study the mechanism of HIV latency and re-activation--we want to understand why and how the virus can remain silent in some lymphocytes [a type of immune system cell] and what are the triggers for the replication of the virus. The virus can be completely asleep in some cells.
We are interested in mechanisms of entry of the virus into cells-- how chemokines--small protein molecules that guide cells--block the entry of the virus.

[Remember: The goal is to flush out and kill the latent HIV virus in "viral reservoirs" that remain in the body even when viral load is considered undetectable.]

One thing we do is test new compounds. We receive compounds from pharmaceutical companies, universities, and small biotech companies, and we check the antiviral activity of these compounds--those that can induce activation of the virus, and some that block the entry of HIV into the cell.

To do this, we check the compounds in recombinant viruses and some cell models [HIV grown in labs rather than from people’s bodies]--they are cheap and sensitive and we can check the induction and replication.

We are studying the mechanisms by which the virus activates.

Right now we are looking a compound, jatrophane diterpene (SJ23B), that triggers SJ23 ( a cell membrane protein). It's a plant extract from a plant called Euphorbia that is found in the Mediterranean. This chemical compound is very useful to reactivate the virus. [The abstract states that SJ23B is 10 times better at activating latent virus than prostratin, another HIV activating compound.]

It's exciting--the compound works using two different mechanisms. When cells are latent, it reactivates the virus. Also, it protects  uninfected cells around any infected cells.
So it activates HIV but decreases HIV infection in culture [in the Petri dish or test tube]. The idea would be to use pulsing treatments—on again, off again.

Next step: To test the compound in mice.
Obstacles: There is not much money for basic science research in Europe.

*  Basic research is essentially test-tube and petri dish research. The work, if it is successful, is eventually tested in people. That is called clinical research.

PD-1 Inhibitors, a Curish Therapy Ready for Clinical Trials

PD-1 (Programmed Death-1--very Star Wars) is a T-cell receptor. Technically, it is a signaling receptor that appears not only on T-cells, but on other immune system cells: B cells, natural killer T cells and macrophages.

For this discussion, though, let's focus just on T-cells. PD-1 signals to T-cells not to activate. T-cell activation is when a t-cell recognizes that cells coming at it are from a particular disease and the T-cells then present a custom package of disease-fighting strategies just for that disease. PD-1 signals to T-cells not to do this.

PD-1 seems to be a way to target latent, HIV-infected T-cells so that they can be killed. Dr. Sandrina Da Fonseca from the  Vaccine and Gene Therapy Institute, in Florida, presented test tube data at the International AIDS Society HIV Reservoirs Conference (remember, when you hear the term "HIV reservoirs," it usually means AIDS cure research). The data showed that T cells taken from people with AIDS that had a lot of PD-1 also had a lot of HIV-1 DNA in them and that contributed to bigger viral reservoirs. 

So: Lots of PD-1 in cells = lots of AIDS genetic material = a bigger viral reservoir.

Photos from the Vienna AIDS Conference-Click for the Whole Image

The media center at the International AIDS Conference in Vienna, 2010

One of many huge statues on the library

Asia Russell, Health GAP member and West Philadelphia neighbor, making it happen at a press conference as broadcast on closed-circuit TV in the media room.

March ended inside the courtyard of Vienna's old library

Your Input: What would you like to ask top AIDS cure researchers?

Hi,

We're here at the two-day Reservoirs Workshop (HIV reservoirs is researcher talk for CURE research).

I'm here with the top AIDS cure researchers in the world. We have some good questions for them:

How much money are you spending to duplicate the Berlin Patient experiment?

How long will it be before we can try Paula Cannon's mice experiment in people?

What would you like to ask top AIDS *cure* researchers?

Great article on AIDS cure research by Jon Cohen

Basically a survey of the top research happening in California right now, much of it funded by the deep-pocketed, publicly funded but little-known California Center for Regenerative Medicine, California's stem cell research agency. Article discusses the Berlin Patient and the research that has followed that case (possibly the first cure of a person with AIDS).

Microblog post from Retroviruses Conference in SF

RT @jsjcroi CURE research and possibilities came up again and again in the opening press conference. After years in limbo, it is back on the agenda [!].