CAR-T therapy – A CAR-T cell therapy technique, long used against difficult cancers, is being tested for HIV in a small clinical study. After a single infusion, two people with HIV reached undetectable viral levels for nearly two years and almost one year and stopped HIV medi
By the time the results were unveiled in Boston. the headline from the study was simple: two people with HIV had no detectable virus after receiving an infusion of their own reprogrammed immune cells.. The treatment—an adaptation of a cancer breakthrough—has pushed into HIV testing as part of a clinical trial focused on safety and feasibility.
Scientists took immune cells from the participants. reprogrammed them in a lab so they recognize and attack HIV in the body. and then delivered a single infusion of those modified cells.. In both individuals. viral levels dropped to undetectable: one case lasted for nearly two years. the other for almost a year.. Just as striking, both participants were able to stop HIV medications entirely.
The early findings were announced last week at the annual meeting of the American Society of Gene and Cell Therapy in Boston.. Steven Deeks. a professor of medicine and HIV expert at the University of California. San Francisco. who led the trial. framed the work as a first step.. “These are early days.. If we can provide the proof-of-concept that this approach is both safe and effective. then there are lots of ways in which it can be optimized. to make it more affordable and scalable. ” he said.
CAR-T cell therapy is not new to clinics.. The approach has been used in tens of thousands of patients with tough-to-treat cancers. and it underpins half a dozen or so approved drugs that rely on the same basic idea: supercharge the immune system to directly attack and eliminate cancer cells.. More recently, the technique has also been used successfully for severe autoimmune diseases.
In the HIV community, the excitement is tethered to a problem that still reaches far beyond biology—access.. Antiretroviral therapy has transformed HIV into a chronic condition by suppressing the virus to undetectable levels. preventing progression to AIDS. and enabling people to live near-normal life expectancy.. But people must take medication for the rest of their lives. and in parts of the world where HIV is still not widely detected—especially in rural and low-income areas—medications may be neither accessible nor affordable.
That backdrop is why even a small study carries weight.. Up until now. there have been under a dozen documented cases of sustained remission from HIV. described as a “functional cure” because the virus is still present in the body but is suppressed to levels that are undetectable by the immune system and HIV medication is no longer needed.. In each of those documented cases, the individuals developed cancer and underwent stem cell transplantations as part of their treatment.
In most of those cases. doctors used stem cells from donors with a rare genetic mutation called CCR5 that naturally prevents HIV from entering and infecting healthy cells.. Timothy Ray Brown—the “Berlin patient”—was the first known person to be cured of HIV in this way in 2008.. “The examples of sustained remission ‘have taught us that the immune system can. under the right conditions. clear HIV. ’” said Boro Dropulić. executive director of the Maryland nonprofit Caring Cross. who developed the CAR-T therapy for HIV.
Still, there’s an obvious tension between what has worked and what can scale.. Dropulić said stem cell transplants aren’t scalable. describing them as intensive procedures that carry serious risks such as graft-versus-host disease. when transplanted cells recognize the recipient’s cells as foreign and attack them.. “What we’re trying to do is to engineer that outcome deliberately without requiring cancer. without requiring a specific donor. ” Dropulić said. adding that his organization is working on making advanced therapies like CAR-T more accessible and affordable.
The promise being tested in this trial lines up with the past cases in a straightforward way: multiple sustained remissions have depended on immune-system control without ongoing medication. and the new approach replaces cancer and donor-based stem cell transplants with engineered cells from the patient—delivered as a single infusion and monitored for how long viral suppression lasts.
For researchers outside the trial. the early signal is exactly the kind of clinical clue the field has been waiting for.. “This is pretty exciting. ” said Andrea Gramatica. vice president of research at amfAR. the Foundation for AIDS Research. who was not involved in the trial.. “The reason this study matters and is particularly important is because it gives the HIV field a real. clinical clue that teaching the immune system to control the virus without antiretroviral therapy is achievable.”
CAR-T HIV immune cells clinical trial viral suppression undetectable HIV antiretroviral therapy functional cure amfAR stem cell transplantation CCR5 graft-versus-host disease