Miranda Smith
Reports of UK HIV cure are misleading
The international media have been at it again this week, with claims of an HIV cure thrown around in a sensationalist click-bait fest, amplified through social media channels and networks around the world. As we’ve warned before, these sorts of headlines should be read VERY carefully.
So what’s behind all this attention, and what is really going on?
Researchers from several institutions in the UK (including Imperial College London, and Oxford and Cambridge Universities) are running a clinical trial. The Research in Viral Eradication of HIV Reservoirs (RIVER) study is trialling a two-pronged approach to reduce the HIV reservoir. It is a small study, aiming to include 50 people who are newly diagnosed with HIV.
In the trial, all 50 participants will be given combination antiretroviral therapy, and half of them will be randomly chosen to get additional treatments to reduce their HIV reservoir. These additional treatments include two separate HIV vaccines (given 8 weeks apart) to boost the immune system, and a short course of an extra drug, vorinostat, to ‘wake up’ latent HIV. This strategy has been described as ‘kick and kill’, with the vorinostat given to kick the latent HIV out of its dormant state, and the boosted immune system ready to kill the newly woken HIV-infected cells. The study researchers have made an animation to explain this strategy.
On Sunday this week, The Sunday Times in the UK reported on the first of the 50 participants to complete the trial. So, ONE man has completed the vaccine/vorinostat combination, and all we know is that he did so safely. The report that he has no detectable virus in his blood is NOT evidence of a cure. Remember, he is on antiretroviral therapy, and most people on therapy do not have detectable virus in the blood. The researchers have not yet looked at his viral reservoirs, and the full results of the trial are not expected until 2018. It is also important to note that the trial will not involve stopping antiretroviral therapy, so it will not be known whether the participants are able to control their virus on their own.
Let’s be realistic about a cure
The RIVER study will be an interesting one to watch, but any reporting at this stage is speculative. The recent headlines have been blown out of proportion from early results from a single study participant. We should wait until the full trial results come out in 2018 before starting to get excited about the potential of the vaccine/vorinostat ‘kick and kill’ strategy.
Details of the CHERUB collaboration, the name for group of institutions involved in the study, can be found here
Full details of the RIVER trial, including the study protocol, can be found here.
More cautious (and realistic) coverage of the results can be read here and here
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