I imagine there is a lot of analysis they would like to do. It took quite a while for them to get their assays right for analysing the Macrophages for clearance. There are other reservoirs that can be problems in different individuals. There are the well known Berlin and Boston patients that had resistance to infection of one HIV reservoir, and I know the Berlin patient - https://en.wikipedia.org/wiki/The_Berlin_Patient - has not needed anti-retrovirals (after a stem cell transplant) due to a low enough level of HIV for the immune system to deal with. I might be wrong, but I believe this is because this patient (and similar) do not have certain cells acting as a reservoir. There was a famous Boston patient who also went through a period of not needing anti retrovirals, and I suspect this may have been due to one (or a few) reservoir(s) being cleared of HIV after a stem cell transplant as well.
In Dec 2016 there was a paper saying that Myeloid Dendritic cells could be cleared of HIV 1. I'm sure that BIT would like to validate the assay used to test this reservoir in the trial patients.
Earlier in July 2013 there was mention of BIT225 crossing the blood brain barrier and that there was potential for microglial HIV (~12.5% of brain cells, and Brain macrophages) reservoir clearance. Problem is you need to get patients Cerebrospinal fluid for testing, and only true "patriots" would want to provide that fluid IMO, or those that are suffering HIV associated dementia (could be a separate trial in itself).
The great hope for the relevant subset of patients is that the more reservoirs you clear of HIV, the more likely your immune system can take of the disease, and you can get off cART etc, which has lots of side effects, and costs a lot of money too. There would be a strong economic motive to take the treatment, let alone feeling better, if you could have a less regular, or one of combo treatment with BIT225. If BIT225 could help clear HIV associated dementia - patients would be desperate for the treatment.
Lots of potential. BIT225 in combo probably doesn't need to clear every single reservoir to be a massive winner. $20m MC seems way too low to me - but then it would as I bought some options.
If I have got anything wrong - I hope somebody will straighten me out. cheers - all IMO and DYOR, DROM etc
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Ann: Significant Immunological Outcomes in BIT225 HIV-1 Trial, page-66
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