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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 …

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 SearchForACure.org, the Fenway Health Center, and the MA Dept. of Public Health

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  • Chart: AIDS Spending in the US, Compared
  • Transcript

    • 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? www.AIDSPolicyProject.org
    • 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 www.AIDSPolicyProject.org March 26, 2011 Boston, Massachusetts
    • 3. HIV Reservoirs
      • Long-lasting groups of cells that are established shortly after HIV infection and can live for decades
      • Cannot be killed unless they are activated.
      • They are actual locations (the brain, the gut)
      • They are populations of cells
      • There is no agreement yet as to how to measure them--size, types of cells, functionality of cells
      www.AIDSPolicyProject.org
    • 4. NEJM Brief Report www.AIDSPolicyProject.org March 26, 2011 Boston, Massachusetts
    • 5. Gero Huetter www.AIDSPolicyProject.org March 26, 2011 Boston, Massachusetts
    • 6. Timothy Ray Brown www.AIDSPolicyProject.org March 26, 2011 Boston, Massachusetts
    • 7. Two current strategies toward a cure
      • Activate resting T cells (cells in the viral reservoirs), and use AIDS drugs to kill them.--Flush them out and kill them off.
      • Repopulate the immune system with cells that have become resistant or immune to AIDS.
      www.AIDSPolicyProject.org March 26, 2011 Boston, Massachusetts
    • 8. Possible curative therapies being investigated
      • HDACi - (Vorinostat)--a drug approved for skin cancer--clinical trials are starting in Melbourne, Australia and Chapel Hill, North Carolina
      • CCR5 gene therapy--Researchers are trying to duplicate the Berlin patient case.
      • 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.
      www.AIDSPolicyProject.org March 26, 2011 Boston, Massachusetts
    • 9. Paula Cannon’s Mice
      • Collaborative effort between John Zaia at City of Hope in Duarte California and Paula Cannon at USC
      • California Center for Restorative Medicine (CIRM) ($15 million)
      • Give the mice human immune systems, infect them with HIV, take out their stem cells, cut out the CCR5 receptor, reinfuse them.
      • CURING MICE. People next?
      www.AIDSPolicyProject.org March 26, 2011 Boston, Massachusetts
    • 10. Jay Lalezari’s People
      • University of Pennsylvania and Quest Research in San Francisco
      • Remove T-cells from long-term survivors
      • Snip out the CCR5 receptors using zinc finger technology (Sangamo, Richmond, CA near Oakland).
      • Reinfuse the cells, this time without their CCr5 receptors
      • Therapy was safe; cells proliferated throughout the body and migrated to the gut.
      • Increase of 100 CD4 cells
      • Almost didn’t happen because of patient enrollment problems
      www.AIDSPolicyProject.org March 26, 2011 Boston, Massachusetts
    • 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. www.AIDSPolicyProject.org March 26, 2011 Boston, Massachusetts
    • 12. www.AIDSPolicyProject.org March 26, 2011 Boston, Massachusetts
    • 13. Obstacles to a cure
      • Lack of funding--NIH spends 3% of its AIDS research budget on a cure.
      • Lack of good ideas--best and brightest aren’t all at the table. Young researchers, foreign researchers, novel ideas.
      • Research models that do not encourage collaboration --Myelin Repair Foundation
      • 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.
      www.AIDSPolicyProject.org March 26, 2011 Boston, Massachusetts
    • 14. What can we do to hasten a cure for AIDS?
      • More funding--$60 M is not enough
      • More funding streams-Opportunity for philanthropists to make a big difference in the course of the AIDS epidemic
      • Make opportunities for new ideas
      • New models of research (in addition to current)
      • Roadblocks in getting INDs, funding
      • Voices of PWAs at the table--clinical trial ethics, enrollment
      www.AIDSPolicyProject.org March 26, 2011 Boston, Massachusetts
    • 15. AIDS Policy Project
      • Diverse group of physicians, lawyers, advocates, community organizers launched a national advocacy campaign for a cure in November, 2009
      • Found demoralized researchers--Larry Kramer and Jay Kostman, MD interview on our web site
      • NIH was not tracking its spending on a cure.
      • Wrote first-plain English report on the cure.
      • Working with NIH and FDA to overcome obstacles and bring more researchers to the table
      • Finding new ideas, new models
      • Turned outward toward the community: writing articles and interviews, blogging, tweeting, etc about AIDS cure research.
      • ORGANIZING
      • www.AIDSPolicyProject.org
    • 16. AIDS Policy Project
      • Grassroots conference on AIDS cure activism May 28, 29, and 30 in Philadelphia
      • Meeting between FDA, NIH, and advocates next month in Baltimore
      • HIV provider conference in Palm Springs, CA on April 9
    • 17. www.AIDSPolicyProject.org 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. www.AIDSPolicyProject.org March 26, 2011 Boston, Massachusetts AMSA and SGAC
    • 19. www.AIDSPolicyProject.org March 26, 2011 Boston, Massachusetts Jose Demarco