The human immune system can handle large bursts of HIV activity and so it should be possible to cure HIV with a 'kick and kill' strategy, finds new research led by UCL, the University of Oxford and the University of North Carolina at Chapel Hill.

The 'kick and kill' strategy aims to cure HIV by stimulating the immune system with a vaccine, then re-awakening dormant HIV hiding in white blood cells with a chemical 'kick' so that the boosted immune system can identify and kill them.

While this approach is promising in theory, it was previously unclear whether the human immune system would be able to control HIV following full-blown reactivation of the virus. The new research, published in Clinical Infectious Diseases, demonstrates that this is possible using a single patient case study.

"Our study shows that the immune system can be as powerful as the most potent combination drug cocktails," explains study co-author Dr Ravi Gupta (UCL Infection & Immunity). ." We're still a long way from being able to cure HIV patients, as we still need to develop and test effective vaccines, but this study takes us one step closer by showing us what type of immune responses an effective vaccine should induce."

The study looked at a single 59 year old man in London who was an 'elite controller', meaning that his immune system could control HIV for a long time without needing treatment. Elite controllers, who make up 0.3% of HIV patients, eventually require treatment to prevent progression to AIDS but they can go a lot longer without treatment because their immune systems are more active against HIV.

The patient in the study had both HIV and myeloma, a cancer of the bone marrow. The bone marrow produces white blood cells, including those that help to control HIV. To treat the patient's myeloma, his bone marrow was completely removed and replaced using his own stem cells. When the bone marrow was removed, the immune system was severely impaired, allowing the HIV to re-activate and replicate. This caused the level of virus in his bloodstream to rise from fewer than 50 copies per millilitre to approximately 28,000 copies per ml before immune function returned.

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