Achieving lasting remission for HIV

A particularly promising finding from the RIO trial was that the antibodies also affected latent HIV hidden in some cells. These reservoirs are how the virus rebounds when people stop treatment, and antibodies are not thought to affect them. Researchers believe that antibody-enhanced T cells can recognize and kill latently infected cells that have even traces of HIV on their surface.

The FRESH intervention, on the other hand, more directly targeted stubborn HIV reservoirs by incorporating another drug, called vesatolimod. It is designed to stimulate immune cells to respond to the threat of HIV and hopefully “shock” dormant HIV particles out of hiding. Once this happens, the immune system, with the help of antibodies, can recognize and kill them.

The FRESH results are exciting, Ndung’u says, “because they might indicate that this diet worked, to some extent. Since it was a small study, it’s obviously difficult to draw very definitive conclusions.” His team is still studying the data.

Once he secures funding, Ndung’u aims to conduct a larger trial in South Africa including chronically infected people. Fidler’s team, meanwhile, is recruiting for a third part of the RIO to try to determine whether pausing antiretroviral treatment for longer before administering the antibodies results in a stronger immune response.

A related U.K.-based trial, called AbVax, will add a T-cell-boosting drug to the mix to see if it enhances the antibodies’ long-lasting, vaccine-like effect. “It could be that combining different approaches improves different elements of the immune system, and that’s the way forward,” says Fidler, co-principal investigator of this study.

For now, Fidler and Ndung’u will continue to follow virally suppressed participants – who, for the first time since receiving their HIV diagnosis, are living without the demands of daily treatment.

This story was originally published in Knowable Magazine.