A Possible New Way to Reach HIV Functional Cure
On 22 May 2014, Professor Mark Wainberg from the Mc Gill University in Montreal announced during the International Symposium on HIV and Emerging Infectious Diseases (ISHEID) held in Marseilles, France, a possible breakthrough towards HIV functional cure using Dolutegravir.
His therory is developped in the interview below:
Professor Wainberg started with the fact that no naïve patient treated in clinical trials with Dolutegravir has developped resistance to this drug.
Furthermore, the emergence of resistance mutation against the associated nukes was also prevented.
Going back to the bench, he was able after several cell passages to finally select, in vitro, 2 mutations at the 263 and 51 positions. However, these mutations were difficult to obtain in patients.
But, when they are selected in vitro, HIV fitness is decreased by 80 percent.
Consequently, the hypothesis is that if we start early-infected patients with Dolutegravir, HIV will not be able to evolve and an effective anti-HIV immune response will be able to develop and finally control it.
However, this theory will have to be proven effective in simian models and in patients.
In patients, it can be addressed by an observational cohort, as Dolutegravir is now licensed to treat patients, and a clinical trial with the design of "proof of concept" study.
But if it is correct, it will be the first time in the history of HIV therapy that a drug will contrary the huge HIV ability to follow Darwinian selection. A new way to funtionally cure HIV would have been discovered by "sabotage" of HIV pathogenesis.
Will Dolutetegravir be able to induce "HIV tolerance" is a hot question we have to answer as soon as possible.
Key words: Dolutegravir, HIV cure, HIV functional cure, HIV resistance to dolutegravir, HIV treatment and cure.