The trial of a potential HIV cure is underway. The scientists involved hope for initial results by November. One of them also has stark warnings about the threat to humanity of future pandemics. He believes that, as seen with HIV and monkeypox, gay men could be the “canary in the coal mine.”
Dr. Marcus A. Conant is a consultant dermatologist whose career pre-dates the first cases of AIDS in the US. He’s now Chief Medical Officer for the biotech company, American Gene Technologies (AGT). It’s been working for the past few years on a groundbreaking HIV cure.
Rather than medication, AGT uses gene technology to boost the capacity of the body’s own immune cells to fight HIV.
A tiny number of individuals are genetically resistant to the effects of HIV. There are cases where people with HIV have undergone a bone marrow transplant and inherited the gene-resistant immune cells from such individuals. This has cured them of HIV.
However, a bone marrow transplant is a risky procedure. Doctors only consider it when someone is fighting a terminal, blood-related cancer like leukemia. It is not a practical, widespread treatment for HIV when medication for the disease already exists.
Instead, AGT wants to use gene technology to produce the same effect. Its process involves removing some white blood cells from an HIV-positive patient and then inserting a gene that modifies them. This enables the cells to stop HIV replication.
Using gene therapy as a potential HIV cure
Hundreds of thousands of the HIV-resistant CD4 T-cells are then infused back into the patient, where they can duplicate and—hopefully—fight HIV.
In 2020, the FDA gave approval for AGT to start a trial involving seven patients. Those patients have had their own genetically-modified T-cells (AGT103-T) infused back into them.
None experienced any negative side effects from the infusion, meaning the trial has now proceeded to its next stage. Each patient has had their antiretroviral treatment stopped. They are being closely monitored to see if their viral loads remain undetectable.
Dr. Conant is not able to give Queerty any advance insight into the trial’s results when we catch up with him via the phone. It’s been kept under wraps until later this year. However, he does say that he and his team are already planning a larger trial.
“It’s what science has always done,” he explains. “You ask, ‘Well which part of it is working? Why do we think that’s working? And how do we make that work better?’
“When AZT came out in 1987, it only worked just minimally. We were able to demonstrate that it was barely prolonging the lives of patients.
“Now here we are 30 years later, with drugs that can suppress the virus essentially to levels so low that patients can have unprotected sex and they don’t transmit the virus. That’s an amazing advance. But it was achieved by asking, ‘What can we do to make it work better?’”
“So there will now be another study, probably in 30-50 patients. My staff and I are designing that study as we speak, to take what we learn from this and treat more patients. We will tweak it to make it even better.”
HIV cure eludes science for more than four decades
Gene therapy has been used to treat several conditions over the past 20 years. This includes severe combined immune deficiency syndrome (SCID) and the eye condition, retinitis pygmantosa.
However, this is the first time it’s been used as a potential treatment for HIV. If it works, it would be groundbreaking.
HIV has proved stubbornly resistant to a cure. It’s something Conant is only too well aware of. He has been working in the field since the early 1980s. As a dermatologist, he saw some of the first cases of men with Kaposi’s Sarcoma (KS) – one of the rare cancers that became the hallmark of AIDS before treatment became available.
Conant was a junior professor at UC San Francisco in 1981. He still vividely remembers seeing his first KS case in April that that year. It was a couple of months before the CDC issued its first public warning of an illness affecting gay men.
HIV, monkeypox and the threat of more pandemics
Because of his experience with HIV, Conant said he felt a sense of déjà vu when he heard of this year’s monkeypox outbreak. Cases in the US have now exceeded 23,00 and the majority are gay men.
Conant says the world must be better prepared for such outbreaks.
“The first thing you see in any epidemic is denial: ‘It can’t happen to us.’
“The second thing you always see is: Someone to blame. And that’s exactly what we saw with HIV/AIDS. And that’s exactly what we’re seeing now with monkeypox: ‘Oh, those gay guys, if they weren’t so promiscuous then the disease would never have happened.’
“No,” he affirms. “The disease was going to happen. It just happened in a special group first. Instead of people blaming the gay community, they should realize this is an opportunity to realize that we’re going to have more and more of these zoonotic diseases, which jump from animals to humans.
“The gay community may well be the first group in which we see this, or in whom we frequently first see this.
“Why is that? Because gay men have opportunities to travel far more frequently than their straight brothers who are raising children and staying at home and don’t have the luxury of being able to pick up any time they want to and go to a party in Spain.
“So all of that is very much like the canary in the coal mine. What’s happening in the gay community is a warning to society: ‘We’ve got a problem here.’
“In the last 40 years we’ve had HIV, you had Ebola, you had Zika, you had Covid, and now monkeypox. That’s five off the top, just in my lifetime, and this is going to continue because people are traveling more.”
Conant agrees with other scientists who say global warming will increase the likelihood of pandemics. Rising temperatures are causing viruses to spread out of their previous habitats.
International solutions to global outbreaks
Conant wants to see a far more international solution to outbreaks, rather than countries just doing their own thing. After all, viruses have no respect for borders.
He also thinks governments must take more steps to allow individuals to isolate themselves when necessary.
“They tell gay men who have the disease, ‘Well go home and isolate.’ In America, a gay man can’t go home and isolate,” he says.
“Sure, you can order in all your food, but if he doesn’t have an income, he can maybe order the food in for a week, and then he’s running out of money. We don’t have an infrastructure set up that makes ‘go home and isolate’ a practical solution.
“If we don’t come up with some way to handle these diseases, we are facing a potential disaster,” he continues. Both Covid and monkeypox have a relatively low mortality rate. He warns that if a disease came along that killed—say—40% of the people who acquired it, “we are going to see societies collapse.”
“We should have learned from AIDS,” says Conant. “Forty years ago, AIDS was the first real clear warning that ‘hey, we need better policies for handling problems like this,’ and we learned nothing. And here we are, after one disease after another, and we respond to each one as if it’s a one-off and it will never happen again.”
David Hudson is a contributing editor at Queerty. Follow him on Twitter at @davidhudson_uk