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HIV Can’t Hide from the Math

For years now researchers have tried to determine the activity of HIV by measuring how much of the virus appears in blood samples – but this doesn’t account for the ability of the disease to hide in body tissue. Using math, researchers have developed a way to examine the true level of the virus’s reproduction.

Antiretroviral drugs will suppress HIV reproduction to such a degree that blood markers may disappear completely – but that doesn’t mean the virus has stopped progressing. It just means the replication process is no longer continuing in the blood. What about lymph nodes and other common hiding places for HIV?

Researchers have never bothered to check this before – it was always assumed that blood samples were a good indicator of what was going on throughout the entire body. New research using mathematical models is now digging deeper to uncover the true state of the disease.

The study involved testing individuals who were taking a mix of three HIV drugs for a period of at least two years – a fourth drug was then added to the mix. In all cases it appeared that the drugs were successfully stopping the spread of the disease. Blood replication was seemingly non-existent. The study did however reveal that progress of the disease continued unabated in other parts of the body despite what the blood was indicating.

In fact, the disease was still ravaging between one and 100 million healthy cells per day. The virus only slowed in replication because it was running out of cells to infect. The replication measurements of three out of the 10 patients involved in the study revealed that there had to be another point in the body at which replication continued with no inhibitions.

It’s bad news for current antiretroviral therapies, which may not be as effective as once hoped – but it is hoped this research will lead to the development of more effective treatment methods.

Despite the Headlines – No AIDS Cure Yet

While headlines from around the world may have made some outstanding claims, the truth is that there isn’t a cure for AIDS – yet! The good news is that all of the patients over whom the fervor has been started over have something in common – they’re all still alive and no longer require treatment. That may sound a lot like they’ve been cured, but there is a the difference.

While all the patients were diagnosed with HIV and treated with antiretroviral drugs, the disease had not yet fully penetrated their bodies’ defenses – the drugs were able to thus act as a defense mechanism to keep the virus from spreading as it usually does. Once those defenses were in place, they could come off the drugs.

So aren’t they cured? No – but they no longer require continued treatment, and that is a huge advancement. Does this mean that we will see HIV patients across the globe coming off of their antiretroviral treatments? Definitely not – unfortunately, the number of patients who would survive when coming off the treatments would be relatively few, and it’s very difficult to know which ones would survive and which ones would suffer rapid progression of the disease. Of course, it’s a chance very few doctors will be willing to take with patients in their care.

However, these events may result in some policy changes when it comes to AIDS. For one thing, people generally need to decide on their own to go somewhere and get tested in order to find out they have the disease. Very few are early enough on in the disease to experience the results of these patients who no longer require treatment. This places the burden on health agencies to seek out high-risk individuals and encourage testing so that the disease can be caught early.

The other adjustment needs to occur on the side of the patient. Many who discover they are HIV positive drag their feet about starting a treatment plan – this needs to stop, as it may make the difference between early treatments stopping the spread of the disease completely, and merely being able to slow it down.

Why should a person with HIV seek treatment immediately? Here are three benefits of catching the disease early and starting an antiretroviral regimen at the first possible opportunity:

  1. They may possibly be able to prevent the need for treatment later on.
  2. It may lead to an increased lifespan.
  3. Risk of spreading the disease decreases by up to 96%.

This is why researchers are calling for the health industry to seek out and test individuals who are in the highest risk categories. Early detection is the key, because HIV hides in the immune system, actually becoming part of the DNA of certain white blood cells. Once this occurs, it isn’t long before the disease spreads to the lymph nodes, bone marrow, and other areas of the body, where it becomes difficult to control and is seemingly impossible to eradicate.

The widely-reported American who received treatment in Berlin was actually getting treatment for leukemia (blood cancer), and the treatment involved bone marrow transplants. He had already been receiving HIV treatments for over a decade, and had to have his bone marrow completely irradiated and replaced. The donor marrow had a rare mutation that made HIV target cells impenetrable to the disease. The result was that he no longer needed his HIV treatments. The disease isn’t cured, but it can no longer spread.

In the United States, the same treatment was repeated on a boy who was being treated for leukemia and is also HIV positive. It will take some time before it is known whether or not the treatment achieved the same effects for this boy as it did for the Seattle native that was treated in Berlin.

The baby who appeared to be cured had a completely different scenario. Full treatment began just over a day after the HIV positive baby was born, although such aggressive treatments are not given until later as a general rule. Treatment continued for one-and-a-half years, when the mother stopped treatment.

After 5 months the baby was tested and seemed to be HIV free. It is now 3 years old. While the baby seems cured, many are skeptical and believe the HIV sequence has simply been buried too deep for testing on such a living person to be viable. Either way, there is no apparent further progression of the disease or need for treatment.

The French patients who stopped their treatment were all part of a group that were started on antiretroviral drugs within weeks or months of contracting the disease – they all continued on the regimen for at least a year, and only about 1 in 7 patients were able to successfully stop their treatments at the end of the study.

So far, scientists can only speculate on why one patient may be able to stop treatment while others need treatment indefinitely to halt the disease. Some have posited that it must have something to do with certain strains of the virus being weaker, while others believe it may have something to with an increased number of CD4 cells in the patient. The problem is that studying the potential for a cure further requires HIV patients who have been recently infected – while scientists don’t have a problem intentionally infecting monkeys to run trials, this would obviously be out of the question for human trials.

Ultimately, HIV is at this point not cured. On a positive note, stopping the spread of the disease across the body is now a much more feasible goal – it has been done by accident, and even on purpose a few times. The trick now is to find a process that guarantees successful treatment instead of relying on poor odds.

Synthetic Agents Used to Weaken HIV

HIV spreads progressively in specific types of cells, often resisting treatment, and one result is chronic inflammation. Researchers are working on an anti-inflammatory treatment that will attack HIV in the immune system cells that it tends to infect.

While antiretroviral treatments are beginning to give HIV patients a more normal lifespan, it is still a crucial time for this new treatment to be developed – the fact is that antiretroviral drugs don’t cure the disease. They can increase a person’s life span, but how is quality of life affected when the virus has many more years to replicate within the body? Inflammation can reach such severe levels that other complications are caused. Such inflammation is also suspected to be associated with the neurocognitive symptoms of HIV.

The CB2 receptor – a protein found on the surface of an immune cell known as a macrophage – may help block central nervous system inflammation. The way this protein is affected by the active ingredient in cannabis may have provided vital data on the prevention of neurocognitive complications.

So why did the researchers focus on macrophages, when it is commonly thought that T cells are the HIV’s immune system hiding spot? Macrophages perform a very specific duty in the body – they are just one of the body’s many types of WBCs (white blood cells), and they are responsible for entrapping and destroying numerous invading cells. Since these cells travel to every part of the human body it is suspected that macrophages are a means by which HIV spreads, including into the brain, thus the potential for neurocognitive symptoms resulting from infected macrophages.

In the studies that were performed a specific enzyme present in HIV replication was observed – in just one week it was revealed that the compound used to activate the CB2 protein was indicating positive results in slowing the spread of HIV. The researchers have therefore proposed that these drugs be administered additional to antiretroviral treatment. The research also supports the notion that the human immune system can be successful in partly counteracting the effects of HIV.

Using these compounds researchers hope to stimulate the body’s natural defenses to counteract HIV symptoms – and while still not a cure, these compounds could continue to enhance the life quality of HIV sufferers.

Smoking + HIV = Bacterial Pneumonia

You’ve heard it before – ‘you need to quit smoking’. But if you have HIV, the plea is even more desperate. A serious complication already common amongst those who are HIV positive is even more prevalent among those who smoke.

One of the most dangerous yet common infections that afflicts HIV patients is bacterial pneumonia. A recent study has shown that HIV-positive individuals who smoke have a 200% greater risk of contracting this life threatening illness than non-smokers with HIV. The study further revealed that when a smoker quits the risk is reduced greatly (although not entirely). Thousands of HIV-positive participants across three continents were involved in this extensive study connecting smoking with a higher risk of pneumonia.

While the risk was still higher for smokers even after quitting, it reduced the risk by about one-third – so it is vital for HIV patients who smoke to make this adjustment. The results were the same regardless of the type(s) of treatment already being received by patients, or the current progression of the disease – the sole factor that altered risk was whether or not the person smoked.

Thanks to antiretroviral drugs those with HIV now have a normal lifespan, but smoking can still reduce it by increasing the risk of this potentially fatal illness. While antiretroviral drugs keep HIV from progressing, they don’t cure the condition – patients still need to take every precaution they can to avoid diseases like bacterial pneumonia.

Researchers want programs to help HIV patients quit smoking to become a part of treatment plans in order to reduce these risks. Once someone is infected it can be extremely difficult for someone with HIV to recover bacterial pneumonia. This serious lung condition is just one of the many reasons individuals who are HIV positive need to quit smoking.

Lab Made Cells Are HIV Resistant

Researchers have found a way to make T cells that can keep HIV at bay in the laboratory – they achieved this by attaching HIV-resistant genes to existing T cells, the cells that are normally the main target of the disease when it reaches its later stages and begins to spread even more rapidly.

The gene used by HIV to enter the cells was isolated and altered to develop resistance within them to the disease – these minor alterations to the T cell can effectively prevent HIV from destroying the immune system and progressing to the AIDS stage.

Not only were the genes themselves affected but activation of a particular receptor in the T cell also occurred – the idea now is to use this process in the human body to create cells that resist HIV.

Those infected with HIV need to take several medications daily in order to avoid progression of the disease – if this gene therapy is to be developed into a viable substitute it will have to be tested, not just in a lab as thus far but clinically.

It is important to note that this is not a cure for HIV – a person given the modified T cells would still have the disease, but the inserted cells would simply halt the progression to prevent it from reaching the fatal AIDS stage. It could still be passed onto others.

The disease has always been tricky because it continues to change inside the body, hence the need for a combination of medications to keep it at bay. This study was part of an attempt to find the right combination of genetic modifications that could perform this process and alleviate the need for daily treatment.

There are two proteins within T cells that are known to be the locations at which the disease enters, and in fact some of the latest medications involve affecting this process. A very limited number of people have a gene that is already HIV resistant, thus preventing its spread throughout their bodies – this is another angle scientists have used to try and modify normal T cells and develop the same resistance within them.

The findings of this study were particularly significant and mark a large step in the right direction of fighting HIV through genetic research.

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