[Viva] Fwd: TreatmentUpdate 232

[shelly tognazzini]

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From: CATIE <mailer at catie.ca>
Date: Mon, Aug 26, 2019 at 12:05 PM
Subject: TreatmentUpdate 232
To: <shetognazzini at gmail.com>


HIV cure research and inflammation
Issue 232

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<https://mailchi.mp/3d01099bdbfe/treatmentupdate-232?e=3006f90030>
[image: CATIE Treatment Update]
HIV cure research

*Potential concern raised with CCR5 interference*
<https://catie.us16.list-manage.com/track/click?u=89abcbccf295c7b8d9a92cf09&id=0e98e33752&e=3006f90030>
In rare cases some people are born with a genetic mutation called the
delta-32 mutation, which makes them naturally resistant to most strains of
HIV. Scientists from California and Denmark analysed data from a large
database called the UK Biobank and found that the delta-32 mutation in
people of British descent was associated with a 21% increased risk of
death. The cause of death is unknown

*Gene therapy—CRISPR starts to move forward against HIV*
<https://catie.us16.list-manage.com/track/click?u=89abcbccf295c7b8d9a92cf09&id=eb02a7d762&e=3006f90030>
One approach to gene therapy that has much potential is called CRISPR
(clustered regularly interspaced short palindromic repeats). Recently,
scientists in the U.S. performed a series of complex and detailed
experiments using a combination of CRISPR and nano-ART in HIV-infected mice.

*Will gene therapy for HIV cause financial toxicity?*
<https://catie.us16.list-manage.com/track/click?u=89abcbccf295c7b8d9a92cf09&id=3d680d02d5&e=3006f90030>
The technology of gene editing through CRISPR has the potential to clear
human genes of the DNA needed by viruses such as HIV. Should this
cutting-edge treatment one day be approved by regulatory agencies in Canada
and other high-income countries, it is likely to be very expensive, as gene
therapies for cancer are. The high price of medicines causes what some
researchers refer to as “financial toxicity” for patients.
Inflammation

*Attention on inflammation also turns to fungi*
<https://catie.us16.list-manage.com/track/click?u=89abcbccf295c7b8d9a92cf09&id=82db83aba9&e=3006f90030>
HIV is associated with excess activation of the immune system and excess
general inflammation. The cause of this is not clear, but one theory is
that HIV infection weakens the intestines, allowing microbes and/or
proteins associated with these microbes to leak through the gut into the
blood. Once in the blood, these microbes and/or their proteins circulate
and contribute to excess immune activation and inflammation. Scientists in
Montreal have performed experiments that strongly suggest that “fungal
translocation” occurs in the gut of HIV-positive people

*Future potential interventions against fungal translocation*
<https://catie.us16.list-manage.com/track/click?u=89abcbccf295c7b8d9a92cf09&id=fde560bc85&e=3006f90030>
The problem of fungal translocation is not reduced by taking ART.
Physician-scientist and fungus expert Martin Hoenigl, MD, from the
University of California at San Diego suggests that different antifungal
agents be tested for their potential to reduce excess HIV-related immune
activation and inflammation. Although broad-spectrum antifungals may be
considered for future studies of fungal translocation, Dr. Hoenigl notes
that emerging antifungal drugs are likely “better tolerated and/or allow
for once weekly [dosing].” Such antifungal drugs are currently in phase II
or phase III clinical trials.
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