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Top 10 Scientific HIV Breakthroughs of 2015

From man-made antibodies specially engineered to fight HIV, to laser beams that could deliver medicine precisely to HIV-infected cells, 2015 was a year of incredible scientific advancements.

Whether the story was about making treatment of HIV easier by eventually eliminating the need for daily pills, or even curing the disease with stem cells, scientific leaps forward offered plenty of reasons to make people smile when an HIV Equal news story came into their news feeds.

Here are 10 remarkable stories from the world of science in 2015 that helped inch us even closer to making HIV a thing of the past.

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    The power and validity of treatment as prevention. (TasP)

    The notion of “treatment as prevention” gained even more momentum in 2015, with research showing that the virus is nearly impossible to pass along to another person if the viral load remains suppressed to levels deemed undetectable.

    The research was presented in July at the International AIDS Society Conference in Australia. It also showed that starting treatment early was the best way to ward off HIV- or AIDS-related complications down the road.

    Read HIV Equal’s complete report from the conference by clicking here.

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    Elite controllers are cure clues.

    In June, scientists at Massachusetts General Hospital and the Ragon Institute examined what happens when HIV infects the dendritic cells of people with HIV who never progress and become sick. These people are known as “elite controllers.”

    The research, published in Plos Pathogens, showed that dendritic cells in particular play a key role in mounting the successful immune response to HIV. Think of dendritic cells as computer hardware for the body – they come standard in everyone. Likewise, imagine T cells as software installed in each of us, actually doing the job of killing viruses. Without the hardware (dendritic cells) working properly, the software (T cells) can’t load and function properly.

    “We are now focusing on fully understanding all the components required to trigger appropriate activation of dendritic cells in HIV infection, which may help to induce an elite-controller like, drug-free remission of HIV in a broader patient population,” explained Dr. Xu Yu.

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    Progress towards a vaccine.

    Using antibodies that come from people infected with HIV, including those known as “non-progressors,” scientists are working to create more powerful antibodies that would pack a more powerful punch. For example, information gleaned from group of antibodies called PG 121 scientists earlier this month reported why this particular group of antibodies could be effective in a vaccine where others have failed.

    Researchers also are designing immunogens (proteins that prime the immune system to create antibodies) in the quest for a vaccine.

    “While many vaccines for other diseases use a dead or inactive version of the disease-causing microbe itself to trigger antibody production, immunizations with ‘native’ HIV proteins are ineffective in triggering an effective immune response, due to HIV’s ability to evade detection from the immune system and mutate rapidly into new strains,” The Scripps Research Institute reported in a June news release. “This challenge has led many researchers to believe that a successful AIDS vaccine will need to consist of a series of related, but slightly different proteins (immunogens) to train the body to produce broadly neutralizing antibodies against HIV—a twist on the traditional ‘booster’ shot, where a person is exposed to the same immunogen multiple times.”

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    Using lasers to zap HIV.

    It sounds outrageous: Using laser beams to zap HIV dead.

    But in this 18-minute TED Talk presented in March in Vancouver, researcher Patience Mthunzi explains how she already is testing an idea to do just that. In test tube and petri dish experiments, cells soaking in solutions containing antiretroviral drugs are pierced with a tiny laser. The cells open up, swallow the medication and close right back up, Mthunzi reported in her talk.

    Mthunzi, a research group leader at the Council for Scientific and Industrial Research in Pretoria, South Africa, said the current method of taking HIV medications by pill leads to too much dilution of the powerful drugs. The pills go through the stomach and the intestines before getting to HIV’s ultimate hiding places, such as the lymph nodes, the nervous system and lungs, she argues.

    Mthunzi said she needs more money to keep her research going, but believes HIV could be treated inside the human body with “three-headed devices” consisting of a laser, a camera, and a sprinkler to deliver medication at the site of infection. “One day if successful this technology can lead to complete eradication of HIV in the body.”

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    Trials of treatment without pills.

    For reasons of convenience, adherence, and in some cases less toxicity, HIV treatment without pills is an exciting goal. In 2015, scientists achieved further progress toward that goal.

    Now in a phase III clinical trial, a manmade antibody called PRO 140 has proven safe and effective. “Every HIV patient in a recent Phase 2b FDA clinical trial, monitored by Amarex Clinical Research, had a much improved quality of life during the trials,” said Nader Pourhassan, CEO of CytoDyn, Inc., maker of PRO 140, in a September HIV Equal story. “Only two sub-cutaneous injections of PRO 140, once a week, were necessary to dramatically reduce viral loads. Instead of the normal regimen of daily pills, they were all sleeping better, had no signs of harm to any organs, had higher energy levels, and their headaches were significantly diminished.”

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    Scientists make headway in stem cell research.

    So far, only one person ever has been cured of HIV, and that is Timothy Brown, also known as “The Berlin Patient.”

    Brown suffered from acute myeloid leukemia and also was HIV positive. He was given bone marrow from a donor who had a rare genetic mutation that makes a person immune to HIV. Bone marrow transplants work because of stem cells. Other factors also likely contributed to Brown’s cure, however. You can read more about Brown’s cure in this report by Science.

    In August, UC Davis obtained a grant to begin clinical trials in people with lymphoma and HIV to try to somewhat duplicate the results seen in Brown.

    “While we’re planning to first test our therapy in patients with lymphomas, our ultimate goal is to expand this treatment to all HIV patients,” said Anderson, co-principal investigator on the grant and a researcher at the UC Davis Institute for Regenerative Cures, in an HIV Equal story. “If we can prove effectiveness in our upcoming clinical trial, this new approach could benefit a large number of HIV positive patients, both with and without HIV-related malignancies.”

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    Alcohol pill flushes HIV from hiding spots.

    Sometimes advances in HIV treatment and prevention are found in surprising places. For example, at this time last year researchers found that the blood of llamas may offer clues for an HIV vaccine, Healthline News reported.

    When scientists this year discovered that disulfiram, a pill used to treat alcoholism, kicked up latent HIV reservoirs, it was a similar “oh wow” moment. In an experiment among 20 healthy, HIV-infected adults (undetectable viral load, or less than 50/ml, and a CD4 count greater than 350), participants were given 500 mg, 1000 mg and 2,000 mg of disulfiram daily for three days, HIV Equal reported in November. “The dosage of disulfiram we used provided more of a ‘tickle’ than a ‘kick’ to the virus, but this could be enough,” said Sharon Lewin, University of Melbourne professor, in a news release. “Even though the drug was only given for three days, we saw a clear increase in virus in plasma, which was very encouraging.”

    Smoking HIV out of its hiding spots has proven a huge roadblock to finding a cure.

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    PrEP on the uptake, eventually coming in other forms.

    A slew of studies came out showing promise for PrEP in new forms beyond daily Truvada, although such developments probably are at least four years off.

    The idea is to make adherence to PrEP easier by using long-lasting injections or even implants to deliver sustained protection against HIV. There also is talk of a PrEP lube (microbicide) and even a PrEP enema, since most people douche before sex.

    The biggest challenge prevention experts face is getting the form of PrEP we already have – Truvada – to the people who need it. In 2016, you can expect more research to emerge from the social science community as to how best to do that.

    You can read HIV Equal’s end-of-year update on PrEP by clicking here.

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    Researchers identify molecule that exposes HIV.

    In May, researchers at the CHUM Research Centre, affiliated with the University of Montreal, identified a way to use a "can opener" to force the virus to open up and to expose its vulnerable parts, allowing the immune system cells to then kill the infected cells, EurekAlert reported.

    “This breakthrough, published in the Proceedings of the National Academy of Sciences, opens a new path in the fight against HIV and could ultimately lead to the design of a vaccine to prevent transmission of the virus. This innovative approach could also be part of the solution for one day eradicating the virus.”

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    Artificial molecule blocks HIV.

    In February, scientists at The Scripps Research Institute announced that they had created a powerful protein eCD4-lg, that stops HIV by blocking two of the receptors where HIV binds to a cell. Their findings were published in the journal Nature.

    “The technique researchers used is similar to other kinds of cutting-edge genetic engineering,” Healthline News reported. “They injected a small strand of DNA into four rhesus monkeys that caused their cells to produce the new HIV blocking protein.”

    Human testing could begin in 2016, the Wall Street Journal reported.

    “The protein is so powerful and the protection it offers is so long-lasting — blocking infection for 8 to 10 months — that scientists speculate it may also someday be used to keep the virus in check in the bodies of people who are already infected,” reported Healthline.