2023-04-18 19:44:57
Forty years after the discovery of HIV, researchers at the Institut Pasteur are continuing their efforts to understand it and limit its progression. They presented their latest findings on Tuesday, April 18. They fuel the hope of a more effective treatment, even of a cure.
By taking an interest in African green monkeys, Michaela Müller-Trutwin, head of the HIV, inflammation and persistence unit at the Institut Pasteur, discovered that they never developed AIDS despite an HIV infection. “What makes you fall ill with AIDS is the multiplication of the virus, explains the researcher. The immune system is activated for years and it gets exhausted,” to the point of no longer being able to respond to infections that affect individuals.
But in these monkeys, the immune reaction is limited and does not exhaust the system. It is based on so-called “natural killer” cells, capable of identifying the infected cells present in the lymph nodes and eliminating them. Now in man, these ganglia are a “virological sanctuary” : HIV multiplies there without the immune system being able to act, the natural killer cells present in humans not being able to identify the cells infected by this virus.
Train cells
Michaela Müller-Trutwin’s research focuses on the possibility of training human cells to recognize HIV and then target it. “The goal is to develop a therapy that improves the immune response. » A preclinical trial carried out on macaques has shown a reduction in the presence of infected cells in the ganglia thanks to these killer cells.
For his part, it is in men that Asier Saez-Cirión, head of the Viral Reservoirs and Immune Control Unit, is looking for treatment solutions. He is interested in “HIV controllers”. These individuals infected with the virus manage to prevent its multiplication. For some, this control is linked to a natural genetic mutation, which makes cells less sensitive to HIV, while, for others, it appears after stopping treatment against the virus.
Patients in remission
“In the laboratory, we try to reprogram the cells of infected people so that they become controllers. » He specifies that this absence of multiplication does not mean that the virus will disappear. It simply becomes undetectable, but remains present in the body. Infected people are then only in remission.
There remains the hope of a complete recovery. Asier Saez-Cirión evokes for this the cases of five people in the world no longer showing any trace of HIV. All have in common a bone marrow transplant performed to treat their leukemia. “This cure is linked to a mutation present in the donor, which affects the cells and prevents the virus from penetrating inside. » If this method has proven itself, the researcher raises its limits: it is expensive, cumbersome, sometimes fatal, and does not always work.
Since the beginning of 2023, the head of unit at the Institut Pasteur has identified 93 clinical trials conducted around the cure of HIV around the world. Even if he wants to be optimistic about the future of research against the virus, he remains nuanced: “We consider that these people are cured of HIV because we no longer find traces of the virus in the cells, but we cannot be sure because we cannot test all the cells. »
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