Steven Deeks, a professor at the University of California, San Francisco, has presented the first data from the duoCAR-T trial, which suggest that a single-dose cell therapy may help some patients control HIV without antiretroviral treatment. At the same time, the researcher urges people not to view these results as a breakthrough leading to a rapid cure for the infection.
Steven G. Deeks is a professor of medicine at the University of California, San Francisco (UCSF) and director of the Delaney AIDS Research Enterprise (DARE), a research consortium funded by the US National Institutes of Health that is dedicated to finding a cure for HIV. In an interview with TheBodyPro, he discussed the results of an early clinical trial of the duoCAR-T gene therapy and explained why, even with encouraging results, it is not yet possible to call this a cure.
The most interest was generated by data from a small study in which patients were administered genetically modified T-cells capable of recognising and attacking HIV. Following the infusion, participants discontinued antiretroviral therapy.
According to Deeks, the study involved nine infusions followed by discontinuation of treatment. In approximately four cases, the researchers observed a certain level of viral control after therapy was stopped.
Two participants deserve special attention. As the scientist noted, ‘one has maintained an undetectable or near-undetectable viral load for about a year, and the other for nearly two years’. At the same time, he emphasises that both patients began HIV treatment very early after infection, which in itself may contribute to better viral control.
Deeks stresses that the key question at present is not how impressive the results look, but whether the intervention itself was actually the cause. “The most important question is whether the intervention made any difference at all. Some people naturally control HIV during a break in treatment even without any intervention,” says the researcher.
This is precisely why the researchers believe it is necessary to conduct a large-scale randomised clinical trial that will allow the effect of the therapy to be distinguished from the natural characteristics of individual patients.
Speaking about the future of the technology, Deeks emphasised the importance of developing solutions that can be applied on a large scale. In his view, in ten years’ time, the need for an HIV cure will be greatest among people who cannot consistently access medical care due to drug supply disruptions, insurance issues or other life circumstances. “We are moving towards something more scalable, ideally a ‘one-time treatment for life’ approach,” says Steven Deeks. “Gene therapy provides the best roadmap for achieving this outcome.”
However, the scientist does not hide the risks. He points out that all current experimental approaches to curing HIV remain significantly more dangerous and less predictable than standard antiretroviral therapy. “Virtually all the approaches to a cure currently under discussion — bone marrow transplantation, antibodies, CAR-T cells — are nowhere near as safe and effective as daily HIV therapy,” he emphasises.
One of the study’s unexpected findings was that the administered CAR-T cells disappeared from the blood within a few weeks. The researchers do not yet know whether this effect could be linked to the cells migrating into tissues or triggering a broader immune response in the body.
Despite the scientific community’s interest, Deeks urges caution in interpretations. “We are trying to communicate these results very carefully,” admits Mr Deeks. “We are still many years away from anything that will truly have a significant impact. As scientists, we are excited about the future, but this is a very, very early stage.”
It is this caution, rather than grandiose claims of an ‘HIV cure’, that is currently the main takeaway from the presented results of the duoCAR-T study. In Deeks’s own words, this is not about a ready-made solution, but merely the first signs that gene therapy could open up a new avenue in the fight against HIV.