HIV Cure Research: Expanding the Ethical Considerations

Ideas and OpinionsOctober 1, 2013HIV Cure Research: Expanding the Ethical ConsiderationsJeremy Sugarman, MD, MPH, MAJeremy Sugarman, MD, MPH, MAFrom Berman Institute of Bioethics, School of Medicine, and Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-159-7-201310010-00694 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Mounting evidence is fueling excitement over the possibility of curing HIV infection. Two “Boston patients” who had bone marrow transplantations (1) and a “Mississippi baby” who was given aggressive antiretroviral therapy (2) soon after birth seem to be free of HIV infection. These accounts add to earlier reports of the “Berlin patient” who lacks evidence of HIV infection after transplantation with cells conferring HIV resistance (3) and members of the Visconti cohort who appear to be free of HIV infection after stopping antiretroviral therapy (4). In aggregate, these findings support the plausibility of “HIV cure research” aimed at eliminating the ...References1. McNeil DG. After marrow transplants, 2 more patients appear H.I.V.-free without drugs. New York Times. 3 July 2013:A10. Accessed at www.nytimes.com/2013/07/04/health/post-transplant-and-off-drugs-hiv-patients-are-apparently-virus-free.html on 6 July 2013. Google Scholar2. Pollack A, McNeil DG. In medical first, a baby with H.I.V. is deemed cured. New York Times. 3 March 2013. Accessed at www.nytimes.com/2013/03/04/health/for-first-time-baby-cured-of-hiv-doctors-say.html on 6 July 2013. Google Scholar3. Hütter G, Nowak D, Mossner M, Ganepola S, Müssig A, Allers K, et al. Long-term control of HIV by CCR5 Delta32/Delta32 stem-cell transplantation. N Engl J Med. 2009;360:692-8. [PMID: 19213682] CrossrefMedlineGoogle Scholar4. Sáez-Cirión A, Bacchus C, Hocqueloux L, Avettand-Fenoel V, Girault I, Lecuroux C, et al. ANRS VISCONTI Study Group. Post-treatment HIV-1 controllers with a long-term virological remission after the interruption of early initiated antiretroviral therapy ANRS VISCONTI Study. PLoS Pathog. 2013;9:1003211. [PMID: 23516360] CrossrefMedlineGoogle Scholar5. Deeks SG, Autran B, Berkhout B, Benkirane M, Cairns S, Chomont N, et al. International AIDS Society Scientific Working Group on HIV Cure. Towards an HIV cure: a global scientific strategy. Nat Rev Immunol. 2012;12:607-14. [PMID: 22814509] CrossrefMedlineGoogle Scholar6. Lo B and Grady C; Working Group on Ethics of the International AIDS Society. Ethical considerations in HIV cure research: points to consider. Curr Opin HIV AIDS. 2013;8:243-9. [PMID: 23422260] CrossrefMedlineGoogle Scholar7. Wilson JM. Lessons learned from the gene therapy trial for ornithine transcarbamylase deficiency. Mol Genet Metab. 2009;96:151-7. [PMID: 19211285] CrossrefMedlineGoogle Scholar8. Ryan B. Misleading news reports suggest HIV cure is near. AIDSmed. Accessed at www.aidsmeds.com/articles/misleading_reports_1667_23916.shtml on 6 July 2013. Google Scholar9. Henderson GE, Easter MM, Zimmer C, King NM, Davis AM, Rothschild BB, et al. Therapeutic misconception in early phase gene transfer trials. Soc Sci Med. 2006;62:239-53. [PMID: 16000230] CrossrefMedlineGoogle Scholar10. Woodsong C and Karim QA. A model designed to enhance informed consent: experiences from the HIV prevention trials network. Am J Public Health. 2005;95:412-9. [PMID: 15727968] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Berman Institute of Bioethics, School of Medicine, and Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland.Some of the ideas described in this article were presented at the International AIDS Society Symposium, “Toward an HIV Cure,” in Kuala Lumpur, Malaysia, on 30 June 2013.Grant Support: In part by National Institute of Allergy and Infectious Diseases, National Institute of Drug Abuse, and National Institute of Mental Health under cooperative agreement UM1AI068619 to the HIV Prevention Trials Network, and the Johns Hopkins Center for AIDS Research, which is funded by the National Institutes of Health (grant 1P30AI094189).Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-1696.Corresponding Author: Jeremy Sugarman, MD, MPH, MA, Johns Hopkins Berman Institute of Bioethics, 1809 Ashland Avenue, Baltimore, MD 21205; e-mail, [email protected].Author Contributions: Conception and design: J. Sugarman.Drafting of the article: J. Sugarman.Critical revision of the article for important intellectual content: J. Sugarman.Final approval of the article: J. Sugarman.This article was published at www.annals.org on 13 August 2013. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics October 1, 2013Volume 159, Issue 7Page: 490-491KeywordsAntiretroviral therapyBiopsyBirthBone marrow transplantationCellsConflicts of interestEmbryonic stem cellsForecastingGene transferHIVHIV infectionsHIV preventionHomicidePeer reviewResearch ethicsScientistsTransplantation ePublished: 8 March 2020 Issue Published: October 1, 2013 Copyright & PermissionsCopyright © by American College of Physicians. All Rights Reserved.PDF downloadLoading ...