HIV Cure Research by Kate Krauss


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HIV Cure Research presented by Kate Krauss, director of AIDS Policy Project at the Fenway Health Center community education conference: An End To AIDS - How A State Bill Can Change Everything hosted by, the Fenway Health Center, and the MA Dept. of Public Health

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  • Chart: AIDS Spending in the US, Compared
  • HIV Cure Research by Kate Krauss

    1. 1. A community perspective By Kate Krauss, Executive Director AIDS Policy Project [email_address] Where are we in the search for a cure for AIDS?
    2. 2. What is a cure? A cure is a permanent remission in absence of requirement for therapy. A functional cure: Control of virus rather than elimination, without requirement for therapy. --The Division of AIDS, US National Institutes of Health March 26, 2011 Boston, Massachusetts
    3. 3. HIV Reservoirs <ul><li>Long-lasting groups of cells that are established shortly after HIV infection and can live for decades </li></ul><ul><li>Cannot be killed unless they are activated. </li></ul><ul><li>They are actual locations (the brain, the gut) </li></ul><ul><li>They are populations of cells </li></ul><ul><li>There is no agreement yet as to how to measure them--size, types of cells, functionality of cells </li></ul>
    4. 4. NEJM Brief Report March 26, 2011 Boston, Massachusetts
    5. 5. Gero Huetter March 26, 2011 Boston, Massachusetts
    6. 6. Timothy Ray Brown March 26, 2011 Boston, Massachusetts
    7. 7. Two current strategies toward a cure <ul><li>Activate resting T cells (cells in the viral reservoirs), and use AIDS drugs to kill them.--Flush them out and kill them off. </li></ul><ul><li>Repopulate the immune system with cells that have become resistant or immune to AIDS. </li></ul> March 26, 2011 Boston, Massachusetts
    8. 8. Possible curative therapies being investigated <ul><li>HDACi - (Vorinostat)--a drug approved for skin cancer--clinical trials are starting in Melbourne, Australia and Chapel Hill, North Carolina </li></ul><ul><li>CCR5 gene therapy--Researchers are trying to duplicate the Berlin patient case. </li></ul><ul><li>Combination strategies to target latency - similar to cancer approaches. These combinations all look promising in vitro eg. HDACi+ methylation inhibitors or other combinations. There may be more than one mechanism of latency or a need for one drug to activate the virus and another drug to kill it. </li></ul> March 26, 2011 Boston, Massachusetts
    9. 9. Paula Cannon’s Mice <ul><li>Collaborative effort between John Zaia at City of Hope in Duarte California and Paula Cannon at USC </li></ul><ul><li>California Center for Restorative Medicine (CIRM) ($15 million) </li></ul><ul><li>Give the mice human immune systems, infect them with HIV, take out their stem cells, cut out the CCR5 receptor, reinfuse them. </li></ul><ul><li>CURING MICE. People next? </li></ul> March 26, 2011 Boston, Massachusetts
    10. 10. Jay Lalezari’s People <ul><li>University of Pennsylvania and Quest Research in San Francisco </li></ul><ul><li>Remove T-cells from long-term survivors </li></ul><ul><li>Snip out the CCR5 receptors using zinc finger technology (Sangamo, Richmond, CA near Oakland). </li></ul><ul><li>Reinfuse the cells, this time without their CCr5 receptors </li></ul><ul><li>Therapy was safe; cells proliferated throughout the body and migrated to the gut. </li></ul><ul><li>Increase of 100 CD4 cells </li></ul><ul><li>Almost didn’t happen because of patient enrollment problems </li></ul> March 26, 2011 Boston, Massachusetts
    11. 11. What percentage of its research budget did the National Institute of Allergy and Infectious Diseases spend on AIDS cure research? In 2009, NIAID spent $40,652,172 on direct AIDS cure research. The total AIDS spending of NIAID in 2009 was $1.541 billion. Thus, NIAID spent less than 3% of it AIDS budget on direct cure research. An additional $20 million was spent on AIDS cure research for the brain at another branch of the NIH. March 26, 2011 Boston, Massachusetts
    12. 12. March 26, 2011 Boston, Massachusetts
    13. 13. Obstacles to a cure <ul><li>Lack of funding--NIH spends 3% of its AIDS research budget on a cure. </li></ul><ul><li>Lack of good ideas--best and brightest aren’t all at the table. Young researchers, foreign researchers, novel ideas. </li></ul><ul><li>Research models that do not encourage collaboration --Myelin Repair Foundation </li></ul><ul><li>Red tape at the FDA/NIH/IRBs based on misunderstandings of what is ethical for people with AIDS. A 3 year wait--and counting--to test one promising therapy in people. </li></ul> March 26, 2011 Boston, Massachusetts
    14. 14. What can we do to hasten a cure for AIDS? <ul><li>More funding--$60 M is not enough </li></ul><ul><li>More funding streams-Opportunity for philanthropists to make a big difference in the course of the AIDS epidemic </li></ul><ul><li>Make opportunities for new ideas </li></ul><ul><li>New models of research (in addition to current) </li></ul><ul><li>Roadblocks in getting INDs, funding </li></ul><ul><li>Voices of PWAs at the table--clinical trial ethics, enrollment </li></ul> March 26, 2011 Boston, Massachusetts
    15. 15. AIDS Policy Project <ul><li>Diverse group of physicians, lawyers, advocates, community organizers launched a national advocacy campaign for a cure in November, 2009 </li></ul><ul><li>Found demoralized researchers--Larry Kramer and Jay Kostman, MD interview on our web site </li></ul><ul><li>NIH was not tracking its spending on a cure. </li></ul><ul><li>Wrote first-plain English report on the cure. </li></ul><ul><li>Working with NIH and FDA to overcome obstacles and bring more researchers to the table </li></ul><ul><li>Finding new ideas, new models </li></ul><ul><li>Turned outward toward the community: writing articles and interviews, blogging, tweeting, etc about AIDS cure research. </li></ul><ul><li>ORGANIZING </li></ul><ul><li> </li></ul>
    16. 16. AIDS Policy Project <ul><li>Grassroots conference on AIDS cure activism May 28, 29, and 30 in Philadelphia </li></ul><ul><li>Meeting between FDA, NIH, and advocates next month in Baltimore </li></ul><ul><li>HIV provider conference in Palm Springs, CA on April 9 </li></ul>
    17. 17. March 26, 2011 Boston, Massachusetts Gero Huetter,MD, physician who cured the first person with AIDS and researcher Steve Deeks, MD at a meeting organized by the AIDS Policy Project at the Zuni Café, San Francisco
    18. 18. March 26, 2011 Boston, Massachusetts AMSA and SGAC
    19. 19. March 26, 2011 Boston, Massachusetts Jose Demarco