Molecule kills HIV as single-day pill offers one-year treatment

Scientists have designed a synthetic molecule
that can reactivate dormant human
immunodeficiency virus (HIV ) in mice and
lead to the death of some of the infected cells ,
according to a study published in PLOS
Pathogens .
The new findings address a long - standing
challenge in HIV treatment: While
antiretroviral therapy can successfully stave
off disease progression, the virus can silently
persist in some cells for many years , so an
infected person must be vigilantly treated for
the rest of their life.
Previous studies have explored potential ways
to eliminate latently infected cells , such as by
stimulating them to produce some viral
particles (“kick ”), followed by cell death via
the immune system or the virus itself (“kill”). A
molecule called bryostatin 1 holds the
potential to trigger a “ kick and kill” response ,
but it is costly to obtain from its source , a
marine animal known as Bugula neritina.
To address this challenge , Matthew Marsden
and Jerome Zack of University of California
Los Angeles ( UCLA) , United States, and
Wender Group colleagues at Stanford have
designed synthetic molecules capable of
imitating the activity of bryostatin 1 and
perhaps even improving on its function . In
the new study, the team tested SUW 133, one
of their more promising synthetic bryostatin 1
analogs .
The researchers first demonstrated that
SUW 133 , like bryostatin 1 , is capable of
activating latent HIV infection in cells
removed from infected patients . Then , they
tested SUW 133 in mice of a strain commonly
used for HIV research , in which the mouse
immune system is modified to be similar to
that of humans.
Molecular analysis revealed that SUW 133
stimulated HIV protein production in latently
infected cells in the mice. Within 24 hours , up
to 25 per cent of these cells then died . SUW 133
was also better tolerated by the mice than was
bryostatin 1 .
These results support the potential for
SUW 133 to be used in a “ kick and kill”
treatment for HIV . Further research is needed
to explore this potential and answer questions
such as whether a greater percentage of cells
could be killed over longer periods of time or
with repeated dosing, whether similar effects
might be seen in humans, and what the long -
term effects of SUW 133 may be .
Meanwhile, for about $ 75 (N 30 , 000) , the
governments in South Africa and Kenya will
soon be able to treat an HIV - infected person
for one year with a pill taken once a day that
contains a “ best - in - class” combination of
three antiretroviral ( ARV ) drugs.
The backbone of the new pill is dolutegravir ,
a remarkably powerful and safe ARV that
inhibits HIV ’ s integrase enzyme and has been
too expensive for most poor and middle -
income countries to afford . The annual per -
person cost of the new pill , made by generic
manufacturers , is also about $ 25 ( N 10 , 000)
less than the least expensive similar triple - ARV
combo pill on the market . “ This is a major
breakthrough, ” says Michel Sidibé, head of the
Joint United Nations Programme on HIV / AIDS
( UNAIDS ) in Geneva, Switzerland .
The new pill , announced today by Sidibé and
others at a press conference connected to the
UN General Assembly meeting in New York
City , will help speed efforts to offer treatment
to all 37 million HIV - infected people in the
world , Sidibé says . Currently , only 19 .5
million are receiving ARVs .
The pill will be offered as a first - line
treatment , and the hope is that its excellent
“ profile ”— powerful suppression of HIV , low
toxicity , and ease of use— will make it simpler
for people to stay on treatment for their
lifetimes and reduce the chances of ARV
resistance emerging .
The other two ARVs in the cocktail are
lamivudine and tenofovir , both of which are
already in widespread use .
South Africa, which has more HIV - infected
people than any country and is the biggest
purchaser of ARVs, estimates it will save $ 900
million over six years .
The pill “ will greatly benefit our patients due
to its superior therapeutic qualities, ” said
Aaron Motsoaledi, South Africa’ s minister of
Health in Pretoria , who said the country
expects to make the first purchase in April
2018 . UNAIDS says the intent is eventually to
offer this in 92 countries .
The new pill , its pricing , and money to
purchase it are the result of a collaboration
between the South African and Kenyan
governments and UNAIDS , the Clinton Health
Access Initiative , Unitaid, the Bill & Melinda
Gates Foundation , the U.S . Agency for
International Development , the United
Kingdom’ s Department for International
Development , and the Global Fund to Fight
AIDS, Tuberculosis and Malaria. Sidibé says
the introduction of the new pill marks a
turning point , with governments , funders , and
public health agencies moving beyond pushing
for access to treatment and coverage of all
infected people to providing the highest -
quality medicine in that universal coverage .
UNAIDS is leading the charge to help end the
HIV / AIDS epidemic by 2030 , which ultimately
will require that 86 per cent of infected people
be on treatment and suppress the virus in
their blood below the level of detection on
standard tests . The new combo ultimately will
help countries achieve this ambitious goal .
“ This will probably change the nature of the
epidemic , ” Sidibé says .