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A study published in Nature Medicine (Nature Medicine 10, 1359 - 1365
(2004)) generated considerable interest in the use of a therapeutic dendritic
cell-based treatment for HIV. In the study, 18 chronically infected and
untreated HIV patients were treated with dendritic cells pulsed with
the patient’s inactivated HIV virus. Viral load levels were decreased
by 80% (median) over the first 112 days following immunization. Prolonged
suppression of viral load of more than 90% was seen in 8 patients for
at least 1 year. This particular dendritic cell-based therapy may be
difficult to develop commercially because of the high viral burden (and/or
the need for ex-vivo expansion of the virus) needed to produce the therapeutic.
However, it suggests that Argos’ approach, which is also patient
specific but requires only a small plasma sample, could be a promising
strategy for treating people with chronic HIV infection.
In a second independent
study (J. Infec. Dis. 191, 1680 (2005)) 12 patients were treated with
dendritic cells pulsed with their own inactivated virus and vaccinated
while receiving antiretroviral therapy. When the antiviral therapy was
withdrawn, 1/3 of the patients had a significant reduction in viral loads
relative to baseline levels and all patients showed a significant reduction
in time to relapse and viral set points. These studies are significant
in that they detail the first immunotherapeutic approaches utilizing
patient-specific therapies to demonstrate durable control of HIV viral
loads.
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