Researchers are making the most of what could be an emerging approach to fight HIV: It takes genes from someone with the virus, and uses them to produce a knock-out antibody that boosts the immune system’s ability to fight back. One global effort is targeting disparities in Africa where people of color have disproportionately high infection rates.
Researchers at the MD Anderson Cancer Center and the The Rockefeller University in New York are now testing whether their aim at promoting diversity among patients will also yield a knockout HIV antibody. A study of 184 Africans being treated for HIV starts Monday at research centers in Botswana, South Africa, Zambia and Nigeria.
“We believe that when we overcome heterogeneity in HIV populations, we can be effective in preventing HIV transmission in countries that have historically had high viral load and low CD4 count infection rates,” said Dr. Francisco Alvarez-Buydens, the head of MD Anderson’s HIV division, in a news release. The study is being funded by The Rockefeller University, the Bill & Melinda Gates Foundation and Becton Dickinson & Co.
Scientists have made considerable progress in creating a vaccine. A version designed to prime the immune system to attack HIV used a short sequence of genetic material called a messenger RNA to induce antibodies called adenoviruses to target HIV like a virus itself.
Researchers now think that if they could replicate the engineered protein using the messenger RNA so it can express the desired function, they can better simulate the original processes of the HIV immune response and boost its ability to act against the virus. They are also searching for the best viral genetic sequences to graft onto the vaccine.
Part of their research is focused on identifying specific HIV genetic material that is inaccessible to HIV and thus also inaccessible to a molecule called messenger RNA. But they’re also still looking for candidates that could be stable and promising enough to undergo long-term use as a vaccine.
“We’re coming back and performing longer-term studies to look at variables that might have an impact on how it functions,” said Dr. Aaron S. Plunkett, director of MD Anderson’s Immunotherapy Program. “We will be picking which people we will focus on in the long term as part of this approach to how to best deliver this vaccine.”
The Ellis Liu HIV Collaborative aims to improve collaboration between scientists and clinicians in Africa to build a more comprehensive HIV treatment and prevention response. Unlike other major global medical projects in Africa such as the ones run by former President Bill Clinton and his wife, UN Secretary-General Ban Ki-moon, the Ellis Liu HIV Collaborative is not tethered to a government agency and it plans to work with anyone willing to participate. MD Anderson researchers contributed initial basic research and updated the published evidence in both human immunodeficiency virus, or HIV, and human leukocyte antigen, or CLL, studies of the interim efficacy of the knockout therapy.
The groundbreaking candidate vaccine and subsequent potent expression of antibodies in short-lived messenger RNA “clusters” would be an important tool in improving prevention and reducing disparities in HIV care and treatment in developing countries, health care experts say.
“If you look at HIV treatment [across the globe], it’s not equal,” Alvarez-Buydens said. “About one in five people live in countries that have lower vaccination coverage. Another factor is that wealthier people are prescribed drugs earlier. As a result, they have more time to become infected and become sick.”
