Crossroads of Cancer and HIV-1: Pathways to a Cure for HIV
- 1Emory University, United States
- 2National Institute of Health (ISS), Italy
Recently, a second individual (the “London patient”) with the HIV-1 infection and concomitant leukemia was cured of both by a conditioning myeloablative regimen followed by transplantation of stem cells bearing the homozygous CCR5 Δ32 mutation. The substantial risks associated with this procedure render it unfeasible on a large scale. This strategy also indicates that a common pathway towards a cure for both HIV and cancer may exist. Successful approaches to curing both diseases should ideally have three components, i.e. 1) direct targeting of pathological cells (neoplastic cells in cancer and the viral reservoir cells HIV-1), 2) the subsequent impediment to reconstitution of the pool of pathological cells and 3) sustained, immunologic control of the disease (both diseases are characterized by detrimental immune hyper-activation that impedes successful establishment of immunity). In this review, we explore medications that are either investigational or FDA-approved anticancer treatments that may be employed to achieve the goal of curing HIV-1. These include: thioredoxin reductase inhibitors (phases 1-3), immune checkpoint inhibitors (phases 1,3), Jak inhibitors (FDA approved for arthritis and multiple cancer indications, summarized in Table 1). Of note, some of these medications such as arsenic trioxide and Jak inhibitors may also reversibly down regulate CCR5 expression on CD4+ T-cells, thus escaping the ethical issues of inducing or transferring mutations in CCR5 that are presently the subject of interest as it relates to HIV-1 cure strategies.
Keywords: HIV, immunomodulator, Inflammation, eradication, latent reservoir HIV infected CD4 T cells; apoptosis of HIV infected CD4 T cells
Received: 18 Jun 2019;
Accepted: 09 Sep 2019.
Copyright: © 2019 Gavegnano, Savarino, Owonikoko and Marconi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Prof. Vincent C. Marconi, Emory University, Atlanta, United States, email@example.com