Post by Nadica (She/Her) on Aug 9, 2024 20:25:15 GMT
Treatments For Long Covid Draw on Decades-Long HIV Research - Published July 29, 2024
HIV and long Covid
Decades of experience studying HIV have helped research teams from Sydney to San Francisco understand the long tail of Covid-19.
In a study released in mid-July, scientists at the Wistar Institute in Philadelphia showed how microbial changes in the intestines of some people living with HIV increased their risk for developing long Covid after a SARS-CoV-2 infection. At the University of California, San Francisco, infectious diseases doctors have applied their expertise looking for HIV reservoirs in the body to track vestiges of the coronavirus in ‘long haulers.’
Now, researchers are looking at whether medications used to treat or prevent HIV may also alleviate long Covid symptoms.
David Putrino, a neuroscientist at the Icahn School of Medicine at Mount Sinai in New York, is awaiting regulatory approval to start testing the effects of the drugs Truvada and maraviroc in a mid-stage trial with collaborators at Yale University and the PolyBio Research Foundation.
The plan is to study each of the 90 participants in detail to understand which immunological characteristics align with signals of efficacy. That information will then be used to formulate patient selection criteria for a larger study, Putrino told me.
Truvada, commonly used as pre-exposure prophylaxis (or PrEP) to prevent HIV infection, can also counter the Epstein-Barr virus — the notorious cause of mono or glandular fever — that can be reactivated after a SARS-CoV-2 infection, Putrino said.
Maraviroc works by blocking a receptor that HIV uses to get into blood cells. That action may also help root out any coronavirus persisting in patients, Putrino said, which he and many researchers believe could be one of several causes of long Covid.
“Our hypothesis is that folks who are showing overt blood-borne signs of SARS-CoV-2 persistence and co-infection reactivation, such as EBV, will be the strongest responders,” he told me.
Bruce Patterson, a former director of virology at Stanford University, says maraviroc helps quell rampant immune dysregulation that can damage the lining of blood vessels, causing blood clots and circulation problems in long haulers.
He plans to test the HIV medicine in combination with low-dose Lipitor, a cholesterol-lowering pill that supports blood vessels, in about 250 long Covid patients in a clinical trial later this year. Patterson, who has treated about 12,000 long haulers, says he’s found the daily drug therapy can relieve symptoms in 6-12 weeks.
Putrino said the findings will provide valuable insights into the drivers of long Covid and strategies for treating them.
“We want to understand how these drugs interact with a complex system and what biomarkers they nudge in what direction, so that we can slowly move toward effective combination therapies,” Putrino said.
If all goes to plan, interim results may be available within 18 months, he said.
HIV and long Covid
Decades of experience studying HIV have helped research teams from Sydney to San Francisco understand the long tail of Covid-19.
In a study released in mid-July, scientists at the Wistar Institute in Philadelphia showed how microbial changes in the intestines of some people living with HIV increased their risk for developing long Covid after a SARS-CoV-2 infection. At the University of California, San Francisco, infectious diseases doctors have applied their expertise looking for HIV reservoirs in the body to track vestiges of the coronavirus in ‘long haulers.’
Now, researchers are looking at whether medications used to treat or prevent HIV may also alleviate long Covid symptoms.
David Putrino, a neuroscientist at the Icahn School of Medicine at Mount Sinai in New York, is awaiting regulatory approval to start testing the effects of the drugs Truvada and maraviroc in a mid-stage trial with collaborators at Yale University and the PolyBio Research Foundation.
The plan is to study each of the 90 participants in detail to understand which immunological characteristics align with signals of efficacy. That information will then be used to formulate patient selection criteria for a larger study, Putrino told me.
Truvada, commonly used as pre-exposure prophylaxis (or PrEP) to prevent HIV infection, can also counter the Epstein-Barr virus — the notorious cause of mono or glandular fever — that can be reactivated after a SARS-CoV-2 infection, Putrino said.
Maraviroc works by blocking a receptor that HIV uses to get into blood cells. That action may also help root out any coronavirus persisting in patients, Putrino said, which he and many researchers believe could be one of several causes of long Covid.
“Our hypothesis is that folks who are showing overt blood-borne signs of SARS-CoV-2 persistence and co-infection reactivation, such as EBV, will be the strongest responders,” he told me.
Bruce Patterson, a former director of virology at Stanford University, says maraviroc helps quell rampant immune dysregulation that can damage the lining of blood vessels, causing blood clots and circulation problems in long haulers.
He plans to test the HIV medicine in combination with low-dose Lipitor, a cholesterol-lowering pill that supports blood vessels, in about 250 long Covid patients in a clinical trial later this year. Patterson, who has treated about 12,000 long haulers, says he’s found the daily drug therapy can relieve symptoms in 6-12 weeks.
Putrino said the findings will provide valuable insights into the drivers of long Covid and strategies for treating them.
“We want to understand how these drugs interact with a complex system and what biomarkers they nudge in what direction, so that we can slowly move toward effective combination therapies,” Putrino said.
If all goes to plan, interim results may be available within 18 months, he said.