401lymphocytes by using an AAV vector system. The infection of several primary
HIV-1 patient isolates can be effectively blocked in the transduced lymphocytes by
combined intra – and extra – cellular binding activities of the neutralizing antibody.
This strategy is useful for the treatment of HIV-1 infected patients.
Personalized Vaccine for HIV
Several vaccines are in development for HIV/AIDS. The fi rst clinical trial of individu-
alized treatment for HIV/AIDS patients using AGS-004 based on Arcelis technology
(Argos Therapeutics) has been successfully completed in Canada. AGS-004 is a vac-
cine made for the individual patient instead of an off-the-rack treatment. The new ther-
apy is based on dendritic cells which are removed from each HIV-infected patient and
subsequently multiplied in vitro. By priming the immune system, as with a vaccine, to
fi ght the specifi c strain of HIV/AIDS infecting a given patient, this would be a more
effective weapon against the virus than the antiretroviral cocktails currently in use.
Not only were there few reported side-effects from the AGS- 004, but the investigators
also measured increased levels of CD8-lymphocytes in the patients thus confi rming
that the intervention was targeted and controlled (Routy et al. 2010 ). Phase II of the
clinical trial is testing the therapy’s effi cacy on its own at eight different sites in Canada.
Personalized Treatment of Hepatitis B
Monitoring of HBV viral load is the most widely used method in assessing liver
disease severity, predicting development of cirrhosis and hepatocellular carcinoma,
deciding about initiation of antiviral therapy, assessing treatment response as well
as early detection of emergence of drug resistance. Clinical outcome and effi cacy of
antiviral treatment might vary with HBV genotype. The importance of covalently
closed circular DNA is also becoming apparent in this regard. Further studies on the
development of newer molecular methods for a better management of chronic hepa-
titis B will minimize morbidity (Chakravarty 2012 ).
Treatment of chronic hepatitis B with interferon (IFN)-α results in sustained loss
of virus replication in as many as 50 % of patients. The immunologic disposition of
the host and genetic factors of the virus itself are probably the main determinants for
an IFN response. There is indeed increasing evidence for the existence of IFN-
sensitivity determining regions in the genome of hepatitis viruses. In this setting,
known predictive parameters for an IFN response, such as hepatitis B virus (HBV)
DNA titers, alanine aminotransferase levels, the degree of liver infl ammation, and
disease duration, must be considered merely as surrogate markers. Mutations in the
HBV gene also infl uence response to IFN. With the increasing progress in nucleic
acid technologies, investigation of viral genetic biomarkers may be integrated in
clinical diagnostic routine.
Personalized Management of Viral Infections