HIV, the virus that causes AIDS, can hide in resting cells, thereby creating a reservoir of itself in cells of individuals who are being treated for the disease. This latent reservoir that exists in memory cells within the immune system (CD4) has been untouchable and remains the largest barrier in curing rather than simply controlling HIV. Now Mayo Clinic researchers have seen early indications in a small clinical trial that a drug may reduce that reservoir. The study appears in The Lancet journal EClinicalMedicine.

Sixteen patients completed the phase one/two trial. The main aim of the study was to determine the safety and tolerability of a weekly dose of the drug ixazomib, which is normally used to treat myeloma. The study was conducted at two specialty medical centers in the U. S. from March 2017 to August 2019.

Findings

The 16 patients who completed the trial tolerated the drug well, and no serious adverse events related to the drug were noted. Analysis also showed indications of a reduction in the HIV reservoir. While not significant, the differences were present and measurable. Fourteen patients showed intact proviruses — viruses integrated into cellular genetic material — prior to the trial. After treatment, 10 of the 14 showed those reservoir viruses were reduced.

“While these findings are preliminary, they are a foundation for future research, and large, controlled clinical trials on ixazomib are clearly warranted,” says Andrew Badley, M.D., Mayo Clinic infectious diseases specialist and senior author of the study.

The study was funded by Millennium Pharmaceuticals, Mayo Clinic, Amfar, and Joseph T. and Michele P. Betten.  A patent for use of ixazomib in HIV-positive individuals has been filed by Mayo Clinic. For a full list of authors, funders and disclosure, see the full paper.