Scientists are taking the offensive in the war on HIV. Rather than suppress the virus in cells indefinitely, researchers at the Sanford Burnham Prebys Medical Discovery Institute want to use drugs to wake it up then kill it once and for all.

Right now, the most common approach to treating HIV is antiretroviral therapy, which, through drugs like AZT and 3TC, prevent the growth of the virus. Problem is, even with this treatment, the virus still hides out in some cells, and these viral time bombs lie dormant in the body, undetected by the immune system. When antiretroviral treatment is stopped, these cells can reawaken — and in turn, alert the body’s immune system — and wreak havoc all over again.

The key to curing HIV, according to lead author Lars Pache, is to quit waiting and shake these cells into revealing themselves — and using a “shock and kill” approach might be the best way to do it.

The study, published in the journal Cell Host and Microbe, describes how the new drugs, known as Smac mimetics, wake up the latent cells through a backdoor approach that “shocks” the virus into waking up — but doesn’t send the body’s immune system into overdrive, which could be deadly. Once the virus is reactivated, the hope is that the immune system will be able to seek out the infected cells and kill them.

This bold approach has been discussed in theory before, but it’s never been put into practice because the available drugs were either too weak to wake up the virus or too strong to keep the immune response under control. The Smac mimetics are promising — and they’re already going through trials for cancer treatment, so they could be waging war in patient cells a lot sooner than we expect.

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