‘Support ‘peripheral science’ — early HIV research helped quick Covid-19 vaccines’

Ravi Gupta is professor of clinical microbiology at

Cambridge University

. His research on HIV highlighted a

possible cure

while his Covid-19 study discovered mutant varieties. Sharing his insights with

Times Evoke

, Gupta discusses the importance of backing ‘

peripheral science

’:
I am an infection doctor and virologist. I’ve been working on HIV for ten years now, including in sub-Saharan

Africa

where my team researched drug-resistant HIV. In 2017, we tried a possible cure in London, when a cancer patient who was HIV-positive was undergoing a stem cell transplant. We injected him with the

cells

of a person whose genetics didn’t have a functional CCR5 fibre receptor, which made them resistant to HIV. It worked — the ‘London Patient’ eventually had no HIV in his system. It’s been over three years now and he hasn’t needed any anti-HIV drugs.



Our work became proof of principle that if you can introduce such a gene mutation into people, it could lead to a cure on a larger scale. Such breakthroughs in

gene therapy

, T-cell therapy and antibody-based therapies are the next frontier in science. There will be different ways of engineering T-cells or white blood cells, programming them to recognise HIV, giving them special properties and infusing them into people — such immunotherapy is on the verge now and the discovery of new treatments for HIV is something I’m looking forward to.

The pandemic also presented our lab with new challenges. Our interest being in the biology of viruses, we studied a patient infected with Covid-19 for over a hundred days — we could document in real time how new variants of the virus would emerge. With the application of therapies, we found the virus actually started changing dramatically. We could see the virus’ real-time evolution — and we noted ‘selection pressure’. When plasma or medication was applied, within days, you could see huge shifts in the genetic make-up of the virus — it started looking more like HIV, in terms of how it was constantly battling against the immune system. The virus genetic had a resistant population that emerged during plasma therapy and then, disappeared when the plasma washed away, the virus shifting back to its older version. When we gave the patient more plasma, the resistant population came back. There was a one-toone corresponding relationship between administering plasma and that specific virus population coming out. The finding was remarkable — this was clearly a selected population and the selection pressure was likely the antibodies. Engineering the mutation in the lab, we found these viruses were less sensitive and weren’t destroyed to the same extent by antibodies as the normal virus.



This research was the blueprint describing how new variants will emerge — in some people, Covid-19 actually learns to defeat the immune system. That’s what makes these new variants so dangerous. We’ll now be testing vaccinated people to check whether the antibodies made by the vaccine can neutralise the B.1.1.7 variant we have in the UK.

An epic battle: Covid-19 variants versus vaccines. Picture courtesy: Ravi Gupta


More broadly, there are important community lessons to be learnt from the pandemic. Earlier, relatively few people cared about HIV research, thinking that the ailment mainly impacted poor people in Africa. But the fact is, the science that came out of researching that virus is directly responsible for the Covid-19 vaccines we have today. The work done on the evolution of HIV enabled us to describe this evolution very quickly and precisely — supporting what people might perceive as ‘peripheral science’ is important because we don’t know where the next threat is coming from and which bit of knowledge will help us stop that. The drugs for HIV were created by scientists studying chicken tumour viruses — that’s where retrovirology came from, not from studying diseases in humans. We would have been at a huge disadvantage now if we didn’t have all that other research. It’s important to spread this message, especially in India, where resources are more limited and the pressure for translational science and research is high. All scientific exploration matters — and sometimes in ways we can’t foresee.



Covid-19 has also shown how scientists can come together in amazing ways. The UK had a problem in testing, with standard labs taking upto three days to deliver results. We had technology which had been used earlier to monitor HIV — this was rapidly developed to give test results within an hour. Such discoveries have been heartening, but it’s also been saddening to see the private sector play a limited role. If we had received more support in the scientific fight against Covid-19, we might have been able to end this in half the time. Instead, today the WHO has half the budget a giant delivery multinational would have just in India. The agency which eradicated smallpox has shrunk just when we need to expand it to protect us. We must revisit these priorities.

What’s wonderful is how the public world over has engaged with science. With pre-printed scientific papers, press coverage and social media, science has become far more accessible to more people now. Science, as it was done in the old days, was often hierarchical, exclusionist, racist and sexist — that old system needed to be updated. Interesting new ways of communicating science will now emerge. I look forward to that while we carry on with our work in the labs.