When Dr. Paul Volberding began treating San Francisco’s first HIV and AIDS patients in the early 1980s, a cure was unimaginable for the gruesome virus that left young and previously healthy victims stricken with cancer, lost to dementia or blind before they ultimately died.
But today there’s not only treatment that can provide those diagnosed with HIV a near-normal life, doctors including Volberding are closer than ever to finding a cure – and believe they will reach that goal in the next five years.
On Monday, the Foundation for AIDS Research (amfAR) announced plans to fund a five-year, $20 million effort to support scientists at UC San Francisco, the Gladstone Institute for Virology and Immunology, the Blood Systems Research Institute and other partners seeking to cure the once-irrepressible virus.
The news came in time for World AIDS Day, which is recognized internationally on Dec. 1 every year to stand in solidarity with those living with the disease, and remember those who died.
Under the leadership of Volberding, the amfAR Institute for HIV Cure Research – which is part of amfAR’s $100 million investment strategy to achieve a cure – will be headquartered at UCSF’s Global Health and Clinical Sciences Building at the Mission Bay campus. The institute will focus on a multi-pronged approach to eliminating the HIV virus in patients.
“This is unlike anything we’ve tried before,” Volberding said. “The foundation was very explicit: they want progress…and they want us to take risks.”
Researchers understand antiretroviral drugs kill HIV and actively infected CD4 immune cells, effectively eliminating the virus from the blood. The virus, however, can remain dormant in a small percentage of infected CD4 cells, known as a latent reservoir. If drug treatment ends the virus can reactivate and infect other cells.
Such reservoirs are what researchers at the HIV Cure Research institute will seek to eliminate.
“The idea is, ‘Can we find those cells?’” Volberding explained, adding that once they’re found, “We wake them up and kill them.”
The effect is known as “shock and kill,” in which doctors bring the virus out of hiding and prevent its ability to return when treatment ends.
Doctors have yet to determine how to kill the virus once it’s shocked, but Volberding and others leading the new institute – including Dr. Warner Greene, co-director with Volberding of the UCSF-GIVI Center For AIDS Research – believe that’s the answer to curing HIV.
“There have been some tantalizing experiments where shocking seems to wake up the virus; most of it is in animal studies so far,” said Volberding. “What we haven’t seen is that shocking the cells hasn’t led to their dying.”
But such a discovery could have life-altering effects for those infected with HIV.
“Getting better at shocking the cells while coming in with something that might kill them; we think that’s the way to go at this point,” Volberding said.
Meanwhile, San Francisco continues to make strides in its “Getting to Zero” initiative that aims to reduce HIV transmission and HIV-related deaths in San Francisco by 90 percent before 2020.
Dr. Susan Buchbinder, director of Bridge HIV at the San Francisco Department of Public Health, said new data set to be presented to the Health Commission on Tuesday points to a continued reduction in new diagnoses and deaths among both men and women, and most ethnic groups.
According to the data, in 2014 in San Francisco there were 307 new infections, and women alone saw just 14 new infections last year. New infections in both men and women of all ethnic groups totaled more than 500 annually from 2006 to 2008.
Additionally, HIV-related deaths have dropped overall from 327 in 2006 to 177 in 2014.
“We’re doing really great at bringing down the rate of HIV associated deaths,” Buchbinder said. “We’re getting people into care earlier and onto treatment, and getting their viral load suppressed and helping them to stay healthier for a long period of time.”
To learn more about The City’s efforts, visit gettingtozerosf.org.
This story has been updated to correct the amount of money that will fund the institute. The new amfAR HIV Cure Research Institute at UCSF, while part of amfAR’s overall $100 million effort to achieve a cure, is getting $20 million.