Exposing Hidden Reservoirs Could Lead to HIV Cure

Proper dosing of Vorinostat can help expose latent HIV.

Scientists at the University of North Carolina at Chapel Hill (UNC) found that interval dosing of the drug Vorinostat reverses HIV latency; however, it does not clear or deplete the virus.

In a study published in the Journal of Clinical Investigation, investigators examined the effect of Vorinostat in 16 patients with HIV whose viral loads were controlled through antiretroviral therapy. The participants received doses of Vorinostat at 48- or 72-hour intervals.

The results of the study showed that HIV was more easily detected within latent CD4+ T cells when Vorinostat was administered once every 3 days, according to a press release.

“We showed that a single dose of Vorinostat could expose the hidden virus several years ago, but it has taken 2 studies over the last 5 years to define the proper interval dosing strategy to use Vorinostat safely and effectively,” lead author Nancie Archin, PhD, said in the release. “Now we can attempt to chip away the viral reservoir.”

No serious toxicities were observed over the course of 1 month of treatment with Vorinostat, and only a few adverse events occurred.

Based on the findings, the investigators believe that pairing a latency-reversing agent with an antiviral immune therapy will be crucial to developing an HIV cure.

“We have now been able to begin 2 small, intensive studies pairing Vorinostat with an anti-HIV vaccine produced by Argos Therapeutics, or with an infusion of antiviral immune cells prepared by Cath Bollard’s laboratory at Children’s National Medical Center, in an attempt to test combined approaches to clearing HIV infection,” David Margolis, MD, director of the UNC HIV Cure Center at the UNC Institute for Global Health and Infectious Diseases, said in the release. “We do not expect immediate success, but hope to make progress towards the goal of developing treatments that someday might clear HIV infection.”

The study was conducted through a collaboration between the HIV Cure Center and scientists in the Departments of Medicine, and Microbiology and Immunology in the School of Medicine, the Gillings School of Global Public Health, and the Eshelman School of Pharmacy.