An AIDS virus genetically engineered to fight other AIDS viruses worked better than expected, suppressing the virus and renewing the immune systems of a few patients, researchers reported Monday.
The study involved just five people, and such an approach needs years more study, they cautioned — but the surprising results offer new hope both for the field of gene therapy and for treating the fatal and incurable AIDS virus.
“The goal of this phase I trial was safety and feasibility and the results established that,” said Dr. Carl June of the University of Pennsylvania School of Medicine, who led the study.
“But the results also hint at something much more,” he added.
“It seemed to have a vaccine-like effect in that the immune system was better in most of the patients than when they enrolled. We are trying to study the mechanism.”
The AIDS virus infects close to 40 million people worldwide and has killed 25 million. A cocktail of drugs can help control infection, but there is no cure and no vaccine.
The drugs cause sometimes severe side effects in some patients and the virus can evolve resistance, so that patients have to move to new drug combinations.
Promise and perils
Gene therapy is a promising but troubled field of research based on the premise that altering genes can cure disease. It has cured only a few patients, and some have developed leukemia as a consequence. One gene therapy volunteer died in 1999.
June’s team tried a new gene therapy approach, first crippling the HIV virus, they report in this week’s issue of the Proceedings of the National Academy of Sciences.
“The virus is gutted so that it only has half the size of the original or pathogenic virus,” June said in a telephone interview.
The so-called envelope gene remains, and is reversed, a manipulation called antisense.
The researchers then recruited five patients with HIV who were beginning to fail treatment, meaning the drugs no longer worked and the virus was beginning to damage their immune systems.
June’s team removed the immune cells, CD4 T-cells, that are attacked by HIV. The researchers infected the CD4 cells in the lab with their newly engineered antisense HIV virus, then infused them back onto the patients.
When HIV or any other virus infects a cell, it injects its own genetic material into the cell. The cell is turned into a virus factory, sometimes pumping out thousands of copies of a virus before it explodes.
Pumps out virus
After the new antisense virus was infused, newly infected cells pumped out defective virus, June said.
“The virus particles that are released are, like, sterile. They are nonpathogenic,” June said.
This test was meant only to show that the approach was safe, and three years later, none of the patients show any ill effects.
The treatment appears to have helped restore the immune systems of four of the five patients, and the virus remains partly suppressed.
“We put back more (CD4 cells) than we took out. We don’t know if that is why their immune system gets better, because there are more soldiers, or whether it got better because of better antiviral effects,” June said.
The therapy is being developed by Gaithersburg, Maryland-based VIRxSYS Corp. and the studies are partly paid for by the National Institute of Allergy and Infectious Diseases.
Phase II trials are underway in HIV patients who have disease well-controlled by drugs. June said it is not yet clear if the treatment could work only in infected patients, or might even be used as a preventive vaccine some day.