UNC Health Talk

The purist: Chapel Hill man shares journey of HIV clinical trials at UNC

Robert Hill has been living with HIV for 22 years. Five years ago, he enrolled in a study at the UNC School of Medicine, which was part of Dr. David Margolis’ ‘kick and kill’ strategy for eradicating HIV by flushing it out of hiding with a drug called Vorinostat and killing it with either a vaccine or with immunotherapies.

Robert Hill, now 55, was living in California when he was diagnosed with HIV on Feb. 24, 1994. At the time, he was given one to two years to live.

“When I was diagnosed, I did some research on it and I found, at the time, there was really only one effective drug on the market, and it wasn’t lasting very long with the patients,” Hill said. “It would last six to eight months and then it would stop working.”

So rather than rely on the uncertainty of drugs, especially in the early days of anti-retroviral drug development, Hill looked inward.

“I decided to completely change my lifestyle: eat right, exercise, stop doing drugs, of course,” said Hill, who was once a heroin user, and is now a personal trainer and health chef.

Hill moved from California to Chapel Hill, where his mother, who is a former director of UNC Cochlear Implant Center, lived at the time.

“I moved out here and started anew,” Hill said. “My goal was to get to a point with my food that I was more or less a purist. I don’t eat anything out of its natural state. I don’t eat anything out of boxes. I drink water and pure cranberry juice. No dairy, no red meat, no pork. That’s it.

“My goal was to be in all the emerging studies and I wanted to be the best candidate for any drug trial. I started to apply to be in those studies, and I was in several,” he said. “The first few batches of drugs would fail and I finally found a batch that worked. I’ve been undetectable for 13 years now.”

Hill’s dramatic lifestyle change wasn’t just for his benefit. It was also to benefit clinical trials and advance research.

“I want the doctors to be able to understand if the drug is not working—not because of how the person is not eating right or not exercising enough—but because the drug, itself, is not working,” Hill said. “I want to be the purest specimen for clinical trials. I need to give something back to society and I think this is a good way to do it.”

“I want to be the purest specimen for clinical trials. I need to give something back to society and I think this is a good way to do it.”

One of the most difficult things about treating the virus is that when a person is infected with HIV, it becomes part of the cellular population of that individual’s immune cells, according to David Margolis, MD, professor of medicine, microbiology and immunology, and epidemiology at the UNC School of Medicine and director the UNC Cure Center and Collaboratory of AIDS Researchers for Eradication. When given certain therapies and medications, an HIV-positive person can display signs that the virus is gone. But it’s not. The HIV virus becomes latent or dormant—essentially hiding within the depths of that person’s own organs and systems.

Margolis and his team at UNC are working to eradicate the virus via a trailblazing method called “kick and kill,”—researchers use a drug to “kick” the virus out of hiding, then “kill” it with either a vaccine or immunotherapies.

“We’re trying to develop a new medical therapy—something that has never been done—the eradication of a viral infection that is integrated into the host’s genome,” Margolis said.

In 2011, Margolis and Nancie Archin, PhD, a research assistant professor of medicine in Margolis’ lab, began a round of trials with a drug called Vorinostat, which was previously used to treat certain cancers. But Margolis and Archin hoped the drug would be the one to “kick” HIV out of hiding. Hill was one of six people initially enrolled in the trial. Archin and colleagues recently identified the proper dosing for Vorinostat, findings that she has submitted for publication.

“I was very blessed to be selected for the trial,” Hill said. “I really trust David Margolis. He’s a really good-hearted person, and I think these trials are really going to be something in fighting AIDS in the future. I feel that UNC has really taken care of us, and I feel UNC is really on the right path toward a cure.

“I take $4,500 worth of drugs every month,” Hill said. “I’ve been on drugs of one sort or another since I was 13 years old. You can understand how excited I am of the prospect of a cure—how excited I am to see what I’m really like not under the influence of all these drugs.”