"You cannot attack an enemy you cannot see or detect unless they get out of their hiding place." These dormant infected cells are why people with HIV require life-long treatment to suppress the virus. "Being able to stop HIV from hiding would be an important part of finding an HIV cure," Dr Mito says.
And now, the cancer drug Venetoclax has been shown to kill hibernating HIV-infected cells. Led by the Walter and Eliza Hall Institute of Medical Research (WEHI) and The Peter Doherty Institute for Infection and Immunity, leading medical research institutes in Melbourne, Australia, a clinical trial on people is underway to assess whether the blood cancer drug can be repurposed towards finding an HIV cure.
At the pre-clinical level, the researchers used venetoclax on human CD4+ T cells donated by people living with HIV who are on suppressive ARVs. The scientists found venetoclax was also able to reduce the amount of HIV DNA in these white blood cells. They also found that the drug delayed the virus from rebounding by two weeks, even without ARVs.
Dr Philip Arandjelovic , co-author in the study, said the discovery is an exciting step towards developing treatment options for the tens of millions of people currently living with HIV globally.
"In attacking dormant HIV cells and delaying viral rebound, venetoclax has shown promise beyond currently approved treatments," he said. "Every achievement in delaying this virus from returning brings us closer to preventing the disease from re-emerging in people living with HIV. Our findings are hopefully a step towards this goal."
"This indicates venetoclax is selectively killing the infected cells, which rely on key proteins to survive. Venetoclax can antagonise one of the key survival proteins," said Dr Kim.
The clinical trial on humans using venetoclax to treat HIV will start at the end of this year in Denmark, with plans to expand the study to Melbourne in 2024.