An experimental drug originally used to treat cancer may help clear HIV from infected cells in the brain, a study has claimed.
The study, conducted at Tulane National Primate Research Center, found that cancer drugs significantly reduced levels of SIV, the nonhuman primate equivalent of HIV, in the brain by targeting and depleting certain immune cells that carry the virus.
The research, published in the journal Brain, may prove to be a big step towards eliminating HIV from hard-to-reach reservoirs where the virus evades otherwise effective treatment.
"This research is an important step in tackling brain-related issues caused by HIV, which still affect people even when they are on effective HIV medication," lead study author Woong-Ki Kim, PhD, associate director for research at Tulane National Primate Research Center, said.
"By specifically targeting the infected cells in the brain, we may be able to clear the virus from these hidden areas, which has been a major challenge in HIV treatment," Kim said
Antiretroviral therapy (ART) is an important component of successful HIV treatment, it maintains the virus at undetectable levels in the blood and transforms HIV from a terminal illness into a manageable one. However, ART does not completely eradicate HIV.
The virus survives in viral reservoirs of the brain, liver, and lymph nodes, thus out of reach from ART. The brain is a challenging region for the treatment due to the blood-brain barrier. Additionally, cells in the brain known as macrophages are extremely long-lived, making them difficult to eradicate once they become infected.
Infection of macrophages is considered to be a contributor to neurocognitive dysfunction experienced by nearly half of those living with HIV. Eliminating the virus from the brain is critical for comprehensive HIV treatment, and has the potential to significantly improve the quality of life for those with HIV-related neurocognitive problems.
Researchers focused on macrophages that carry HIV in the brain by using small molecule inhibitors to block a receptor that increases in HIV-infected macrophages.
Researchers were able to reduce the viral load in the brain successfully, by clearing the virus from brain tissue, ultimately providing a potential new treatment avenue for HIV.
The small molecule inhibitor used by the researchers was BLZ945, which has been previously studied for therapeutic use in amyotrophic lateral sclerosis (ALS) and brain cancer, but never for clearing HIV from the brain.
Researchers used three groups to model human HIV infection and treatment: an untreated control group, and two groups treated with either a low or high dose of the small molecule inhibitor for 30 days.
The high-dose treatment showed a notable reduction in cells expressing HIV receptor sites and a 95-99 per cent decrease in viral DNA loads in the brain.
Researchers suggested the next step is to examine this therapy with ART to assess its efficacy in a combined treatment approach.
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