Friday June 8, 2007 SGN.org |
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Volume 35 Issue 23 |
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Tuesday, Oct 14, 2008
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| HIV: Search For A Cure Continues |
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By David Scondras -
hope@sfac.orgSpecial to the SGN Cure? Once again we are hearing about efforts to eradicate HIV, at least in some people. These efforts are being made, not by marginal actors, but by the country's top doctors. On May 24th the Bloomberg report (Bloomberg.com) headlined the issue this way: -Top U.S. Scientist to Use New AIDS Drugs Seeking Cure" (the scientist referred to is Anthony Fauci, longtime director of many HIV research efforts at the National Institutes of Health); http://www.bloomberg.com/apps/news?pid=20601087&sid=a.0x1mlV37Qw&refer=home A summary of scientists' efforts exploring the possibility of eradication can be found on: http://www.thebody.com:80/content/news/art41026.html?m201h So what happened? Well, for many years it has been clear that after HIV gets into the body, it starts infecting lots of cells. It writes instructions onto the cells' operating system which turns the cell into a factory making HIV when the cell is turned on. These instructions written on the cell's operating instructions are called 'provirus'. Anyway, when you use strong antiretrovirals and check a person's cells after most of the virus has been eliminated from the bloodstream, you can still find some cells that have these instructions. Provirus does not make virus until the cell containing it is 'turned on' which does not happen in some cells for a long time. No one has ever known exactly howHOW long this is. For this reason, most scientists, doctors and activists have been very skeptical about getting a cure for HIV. It would be necessary to get rid of all cells containing provirus including the ones which are not turned on called 'latently infected'. Unfortunately, the drugs we have do not get rid of these latently infected cells. Latently infected cells are in fact eliminated, just not directly by our medicines. There are two different theories that might explain why HIV does not disappear altogether with the use of antivirals. The first is that some infected cells which are not turned on can hang around for twenty or thirty or forty years, and spring into action making more virus as soon as antiviral medicines are withdrawn. The other is that the medicines we have been using do not shut off all replication, just most replication, and that is why when they are stopped, the virus comes back. This leads us to a hopeful possibility. If we could eliminate virtually all infected cells with the help of antiretrovirals, the immune system might be able to get rid of the few infected cells that are left. This is the operating theory behind radiation treatments for cancer. How can we find out which theory is correct? First we would use the new powerful antivirals now available which perhaps can shut down all replication completely and see if the body clears the infection. After testing to make sure no virus or provirus can be found, we would then stop using the powerful drugs and see if the virus comes back. And this extraordinary experiment is taking place right now. Why now? First, because it has been discovered that in fact latently infected cells, containing provirus, DO get eliminated from the body. It is not clear why or how, but the data shows that the body does in fact get rid of these latently infected cells (provirus). Dr. Fauci's group studying this found that in seven HIV positive people who have used strong antivirals early in the illness, there was a reduction in the amount of provirus by 50% every 4.6 months. If these results hold up, the scientists estimate that 7.7 years of the combination therapy could possibly eliminate HIV. Second, because there are new powerful drugs, entry inhibitors and others, which can be used to shut down viral replication, perhaps completely. So this process might happen faster and hopefully completely. The experiment is underway. Patients will be dosed with the powerful new antivirals to hopefully shut down replication altogether for one year, and then they will be taken off medication assuming no virus can be found to see if the virus comes back. This is an experiment which needs to be done, and it's fine to hope for good results. But there are good reasons to think it will not work, and we should not raise our expectations too high. Perhaps it will work in a few people but not everyone. Perhaps it will work for a limited period of time in some people, giving them a vacation from meds. Perhaps it will succeed completely and we can look forward to a cure. The world will be waiting to hear the results. David Scondras is the founder of Search For A Cure. He developed the nationally-recognized HIV treatment series, Reasons for Hope. All articles in the series are reviewed by expert HIV doctors & scientists as well as an HIV positive & negative focus group to ensure both accuracy and understandability. This article has been reviewed by Alfred DeMaria, Jr., M.D. Chief Medical Officer, State Epidemiologist Director, Bureau of Communicable Disease Control State Laboratory Institute And Dr. Cal Cohen of Community Research Intiative of New England. Any errors are entirely those of Search For A Cure, not our reviewers. If you have any questions or would like to receive the Reasons for Hope series contact Search For A Cure at 617-945-5350 or e-mail at hope@sfac.orgg . Please visit our web site at www.searchforacure.org. Search For a Cure is a not for profit organization providing education, promoting access & advocating the basic human right to safe and effective treatment for all people living with HIV/AIDS. |
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