AIDS Cure Possible, Study Suggests

Aug. 11, 2005 - A small human study may point the way to a cure for AIDS.

Behind the stunning results is a totally new approach to HIV treatment. It makes use of an epilepsy drug -- valproic acid -- that flushes HIV out of its most remote hiding places in the body.

Combined with powerful HIV drugs, the approach might totally eliminate the AIDS virus from the body. That promises a cure for AIDS, says study leader David M. Margolis, MD.

"This might lead to a therapy that would clear virus from an infected person, or reduce it to such a low level they would not need treatment for a very long time," Margolis tells WebMD. "But that is only a hope for the future. It will require a lot more work. Today, HIV is still a problem."

The Margolis team's groundbreaking report appears in the Aug. 13 issue of The Lancet. Accompanying it is an editorial by McGill University researcher Jean-Pierre Routy, MD, PhD.

"This is very serious data -- a very exciting piece of information," Routy tells WebMD. "For the first time, the disease may be attacked in the last cells where it is hiding. That is a sign of hope. We can expect one day to remove all these infected cells."

HIV in Hiding

A decade ago, there was great optimism that powerful AIDS drug combinations would eliminate HIV from the bodies of infected people. These highly active antiretroviral therapies -- HAART -- put the AIDS virus on the defensive. The drugs kept HIV levels so low, it was hoped that the virus would soon vanish from the body.

That didn't happen. The reason: latent HIV. Latent HIV is inactive virus planted deep in the DNA of human cells. There it lies in wait, beyond the reach of anti-HIV drugs. This tiny, smoldering infection is enough to burst into full-fledged AIDS once a person stops taking HAART.

Researchers have tried everything, from years of toxic drugs to bone marrow transplants, to get rid of latent HIV. None of it worked. Making this even more maddening were recent findings that this last reservoir of HIV infection is very small.

"The total amount of infected cells is very small: just 1 gram in a person with normal body weight," Routy says. "But until a few weeks ago it was impossible to attack these cells."

One of the scientists trying to crack the riddle of HIV latency is Eric Verdin, MD, associate director of the Gladstone Institute of Virology and Immunology at the University of California, San Francisco.

"Everyone has been talking about doing this for 10 years, and [Margolis' team] is the one that has done it," Verdin tells WebMD. "A lot of people in the field have been thinking about flushing out the latent HIV pools. The reason we have not been more active is because there were no good drugs known to do this."