At the General Hospital of Toulon, France, we will initiate a new strategy in October to get patients to this functional cure status.
Online PR News – 21-August-2014 – Toulon, Var, France – HIV infection concerns 34 millions of people worldwide. Those who can afford life-long combined antiretroviral therapy (cART) can expect a normal life span, if no side effects are occurring.
Despite undetectable viremia on cART, HIV remains hidden in cells and tissues, which are called HIV reservoirs. Each time cART is stopped, viremia rebounds and immunity falls.
Unfortunately, no vaccine, either preventive or therapeutic is on the horizon. Therefore we have to find new ways to achieve HIV functional cure, which is HIV replication control without continuing cART. This has been observed in a limited number of patients treated 2 years at the time of primary HIV infection and, also, spontaneously appears in 0.1% of patients called the Elite Controllers.
Inducing this state is a scientific challenge as it needs to diagnose patients early, and uses a combination of expensive antiretrovirals.
At the General Hospital of Toulon, France, Doctor Lafeuillade will initiate a new strategy in October to get patients to this functional cure status. It will concern patients with CD4 cells above 500/mm3, naïve of antiretrovirals and with a viral load above 4 logs. They will receive one other day Dolutegravir, a new HIV integrase inhibitor, and Lamivudine (3TC), an RT inhibitor: one day Dolutegravir (50 mg), one day Lamivudine (300 mg) and vice versa.
Both drugs are able to alter the fitness of HIV. Consequently they will induce a crippled HIV unable to replicate. That’s why these drugs are not given when viral load is below 4 logs: to be able to induce resistance mutations (so a low viremia is needed) as it is known that Dolutegravir + Lamivudine can decrease viral load of 3 logs.
The R263K mutation and the M184V mutation induced by these drugs will impair HIV replicative capacity. They will be given until the mutations are selected, then stopped.
Preliminary results on this kind of HIV cure are expected for the end of 2015.