This Brief describes the concept and realization of gene therapy for HIV from the unique historic perspective and insight of two pioneers of the clinical applications of stem cell gene therapy for HIV. Gerhard Bauer applied ribozyme-anti-HIV and other vectors to manufacture clinical grade, HIV-resistant hematopoietic stem cells for the first patients that received stem cell gene therapy for HIV, including the first child in the world and the first fully marrow-ablated HIV infected patient. Joseph Anderson developed the most recent and most potent combination anti-HIV lentiviral vectors and pluripotent stem cell applications for HIV gene therapy and tested these in the appropriate in vitro and vivo models, paving the way for novel HIV gene therapy approaches to possibly cure patients. In Gene Therapy for HIV, Bauer and Anderson discuss the unique aspects of this therapy, including its limitations and proper safety precautions and outline a path for a possible functional cure for HIV using stem cell gene therapy based on a cure already achieved with a bone marrow stem cell transplantation performed in Germany using donor stem cells with a naturally arising CCR5 mutation. In addition, the Brief provides a thorough and methodical explanation of the basics of gene therapy, gene therapy vector development, in vitro and in vivo models for HIV gene therapy and clinical applications of HIV gene therapy, including Good Manufacturing Practices.

ince the early 1980s, the HIV epidemic has been raging within the S 1 United States and around the world. Drug therapy for HIV infection has not been curative, prompting the search for alternative strategies to control HIV infection within infected persons. One potential alterna tive to drug therapy is a developing medical technology termed gene therapy. 2 Gene therapy involves introducing genetic elements into popu lations of cells in order to correct or prevent a pathologic process. A large number of gene therapy strategies have been developed in an at tempt to inhibit HIV expression and spread. These strategies fall into two general categories, genetic modification of cells in order to elicit an immune response against HIV and genetic modification of the target cells of HIV infection in order to block HIV expression and reproduction. In the first strategy, termed genetic immunotherapy by some, genetic material encoding HIV proteins is introduced into patient's cells in order to stimulate a cellular immune response above and beyond 3 5 that stimulated by the viral infection itself. - Two general genetic im munotherapy strategies have been developed. Genes encoding HIV pro teins have been directly injected into the dermis or muscle tissue of patients. These genes have been encoded in plasmids or viral DNA and have been injected either in the form of naked DNA or complexed with lipids.

This book centers on gene therapy and gene transfer approaches to prevent or treat chronic virus infections. The main focus is on the Big Three: human immunodeficiency virus (HIV-1), hepatitis B virus (HBV) and hepatitis C virus (HCV). Ample anti-HIV drugs are currently available in the clinic and the development of an effective combination therapy has dramatically improved the lifespan and quality of life of infected individuals. A similar trend can already be recognized for HBV and HCV: the development of multiple (directly acting) antiviral drugs and plans to control or even cure the infection. However, approaches that help prevent infection, or which provide long-lasting treatment (such as a cure) remain important goals. Immunization through gene transfer vehicles encoding immunogenic viral proteins shows promise in preventing infections with complex, highly variable, viruses such as HIV-1 or HCV. Gene therapy applications for virus infections have been discussed since the early 1990’s. Whereas a true cure seems difficult to achieve for HIV-1 due to its intrinsic property to deposit its genome into that of the host, such attempts may be within reach for HCV where spontaneous viral clearance occurs in a small percentage of the infected individuals. The prospect of original gene therapy approaches may provide alternative ways to reach the same endpoint by, for example, silencing of CCR5 expression post-transcriptionally. Many alternative antiviral strategies have been developed based on a variety of novel molecular methods: e.g. ribozymes. Some studies have progressed towards pre-clinical animal models and a few antiviral gene therapies have progressed towards clinical trials. This book provides an overview of this rapidly progressing field, while focusing on the interface of gene therapy and immunology/vaccinology.

This book focuses primarily on the development of effective gene therapy approaches for HIV infection, including the improvement of gene transfer vectors, procedures for the ex-vivo manipulation and transduction of T-lymphocytes and hematopoietic stem cells, and preclinical testing of HIV inhibition strategies. It provides a balanced perspective of the many accomplishments in this field as well as the problems which need to be solved in order to develop safe and effective therapies which benefit persons with HIV infection.

Gene Therapy for Viral Infections provides a comprehensive review of the broader field of nucleic acid and its use in treating viral infections. The text bridges the gap between basic science and important clinical applications of the technology, providing a systematic, integrated review of the advances in nucleic acid-based antiviral drugs and the potential advantages of new technologies over current treatment options. Coverage begins with the fundamentals, exploring varying topics, including harnessing RNAi to silence viral gene expression, antiviral gene editing, viral gene therapy vectors, and non-viral vectors. Subsequent sections include detailed coverage of the developing use of gene therapy for the treatment of specific infections, the principles of rational design of antivirals, and the hurdles that currently face the further advancement of gene therapy technology. Provides coverage of gene therapy for a variety of infections, including HBV, HCV, HIV, hemorrhagic fever viruses, and respiratory and other viral infections Bridges the gap between the basic science and the important medical applications of this technology Features a broad approach to the topic, including an essential overview and the applications of gene therapy, synthetic RNA, and other antiviral strategies that involve nucleic acid engineering Presents perspectives on the future use of nucleic acids as a novel class of antiviral drugs Arms the reader with the cutting-edge information needed to stay abreast of this developing field

Tremendous progress in the understanding of the immune pathogenesis of HIV disease has been made in the last two decades like in no other field of science ever before. Besides the inhibition of viral replication with highly active antiretroviral therapy (HAART) immunoreconstitution remains an important mainstay to be achieved in the battle against HIV. Intensive research has led to worldwide phase-III studies of immunotreatment of HIV infection such as the SILCAAT and ESPRIT trials to boost existing immune responses and to restore the immune system leading to the control of viral replication. The science and practical management of immunotherapy of HIV patients is described by famous experts from immunology, virology, gene therapy, dermatology, and clinical medicine.