Translating Science into Action: Killing the Sleeping Giant - Eliminating HIV/AIDS from the Body
Nov 21, 2017 12:00 PM
Adam Spivak, MD, an assistant professor in the department of medicine, was guided by two important milestones early in his life while working toward a career in medicine. He wanted to emulate his father, a doctor and scientist. Spivak also grew up in the 1980s when the world awakened to a terrifying pandemic¾HIV/AIDS¾that was poorly understood by the scientific community.
Prior to a cocktail of medications, the HIV virus led to the development of Acquired Immune Deficiency Syndrome (AIDS), a life-threatening disease that attacks a person’s immune system leaving them vulnerable to a myriad of pathogens and typically benign conditions. The advent of combination antiretroviral therapy has relegated HIV to a chronic condition. While this therapy has reduced the viral load in patients to such small quantities that it falls below the limit of detection (<20 copies per drop of blood), it does not eliminate the virus from the patient’s body. The virus lies dormant, hidden in resting memory T-cells. If combination therapy is stopped, the viral counts will rebound, and symptoms associated with HIV/AIDS will return. To date, the virus has stymied the medical community on how to defeat it.
Spivak used opportunities through the VPCAT and KL2 scholars program to launch a career as an independent physician scientist with a focus on improving the management of HIV infection. Specifically, Spivak wants to eliminate the virus from the body. Previous attempts on this front have either been too toxic or too tolerant for the patient and proved ineffective at the intended goal.
Spivak has taken a step back and returned to the drawing board to find alternate drugs that had a unique way to get the virus to peak out and replicate again. Once reactivated, the body’s immune system can see this small reservoir and attack it, hopefully eliminating it from the body¾a treatment for HIV/AIDS.
In his research, he identified Ingenol dibenzoate, a naturally occurring compound isolated from medicinal plants called euphorbiacaes. These plants have been used in traditional medicine for centuries. Ingenols do not have inherent activity against HIV/AIDS, but the side chains on the Ingenol structures empower the compound, giving it activity against the hidden virus
Spivak, along with his scientific mentor, Vicente Planelles, PhD professor in the department of pathology, recently published a description of a rapid ex vivo system to screen candidate compounds using cells obtained from HIV-positive individuals currently taking combination drug therapy. This screening tool will allow researchers to identify promising drug candidates and assess for potential toxicities in order to inform pilot HIV eradication clinical trials.
"The support of the University of Utah CCTS, through the availability of core resources, the VPCAT leadership and mentoring program, and direct KL2 research funding, has been absolutely critical in achieving this career milestone,” says Spivak. “The University clearly prioritizes the career advancement of new investigators, a distinguishing characteristic that sets it apart from other top academic medical centers."
Stacy W. Kish, email@example.comScience Writer, University of Utah Health