The second instalment of the SFU President’s Dream Colloquium on January 22nd brought to the stage Dr. Zabrina Brumme, Director of the BC-CfE Laboratory program. Dr. Brumme, who shares her expertise on HIV cure research internationally, joined the BC-CfE in 2018. In her colloquium lecture and a subsequent BC-CfE-hosted webinar, she provided a clear look into why we need a cure and how it may be achieved. “A cure for HIV is not in sight, but many believe it is feasible,” she said. “It’s important to realize that if we’re going to get there we’ll get there together-scientists, clinicians and community.”
Here are a few key takeaways, providing a 101-level introduction to what is happening in HIV cure research.
Treatment is not a cure: Current HIV treatments, while very effective in increasing longevity and quality of life for individuals living with HIV, are not a cure. Completely new strategies are required to reach a cure, and major research efforts are currently dedicated towards this goal.
A cure must eradicate latent HIV: The challenge with HIV is that copies of the virus can persist for years-decades, as shown by recent research by Dr. Brumme and her team at the BC-CfE-in what are known as viral reservoirs. The HIV virus is continually evolving when it’s actively replicating within an individual. And during this time, mutated copies of the virus get “archived” into the viral reservoir, where they can persist. The reservoir is called “latent” because these viral copies are not currently active; however, they can reactivate at any time to produce infectious HIV. While HIV treatment effectively curbs HIV replication, it does not eliminate the viral reservoir. Curing HIV will require elimination of the viral reservoir-and scientists are actively pursuing multiple strategies to do this.
A total HIV cure will remain out of reach for some time, but scientists are making slow and steady progress towards achieving “HIV remission”: This is a state where a person’s viral reservoir would be reduced or controlled such that they could stop taking antiretroviral treatment without risk of viral rebound. Individuals in HIV remission, however, would still be considered HIV-positive. Hypothetically, cures for HIV could be customized: An HIV cure, once achieved, is unlikely to be a “one-size-fits-all” approach. Instead, it will probably comprise a “personalized” combination of multiple approaches to achieve sustained viral remission. These approaches would be tailored to an individual’s HIV strain, reservoir size and the unique characteristics of their immune system.
HIV cure research is collaborative: “From the very beginning, HIV cure research has been conducted from an interdisciplinary perspective: scientists, clinicians, community, and patients are working together towards this common goal. HIV cure research is bringing us all together,” concluded Dr. Brumme.
The full webinar with Dr. Zabrina Brumme is available online.