Breaking news We now have a path to a cure for HIV

 

‘We now have a path to a cure’: Researchers pinpoint how HIV hides and grows inside the body even when undetectable in blood

HIV continues to replicate in the body even if it’s undetectable in the blood after antiretroviral treatment, scientists have discovered.

It explains how the virus rapidly bounces back – and keeps growing – after a patient stops taking antiretroviral drugs.

 

Study author Dr Steven Wolinsky, chief of infectious diseases at Northwestern’s Feinberg School of Medicine, said: ‘We now have a path to a cure.

‘The challenge is to deliver drugs at clinically effective concentrations to where the virus continues to replicate within the patient.

 

Potent antiretroviral drugs are able to seemingly get rid of HIV from the bloodstream in most patients. After the treatment, their blood tests may not detect the virus.

However, HIV is still growing in a viral reservoir within the lymphoid tissue in the body at that time.

And, it ‘quickly rebounds’ in the blood after patients stop taking the drugs.

Scientists concluded that latently infected cells or ongoing low levels of HIV replication maintain those viral reservoirs during antiretroviral treatment.

Scientists long believed that the reservoir only contained long-infected cells in a resting place – instead of newly infected cells. The study is exciting because it really changes how we think about what is happening in treated patients. It helps explains why some strategies that tried to clear the reservoir have failed 

 

Dr Angela McLean, a professor of mathematical biology at Oxford University

That’s because none of them had seen viruses with new genetic mutations that arise when HIV completes its growth cycles. Furthermore, most patients don’t develop drug resistant mutations – which would seem likely if HIV was growing in the presence of drugs.

The study analyzed viral sequences in serial samples of lymph node cells.

 

They also examined blood from three HIV-infected patients.

Each of those patients had no detectable virus in their blood. The scientists determined that the viral reservoir was constantly replenished by low-level virus replication in the lymphoid tissue. Infected cells would then move from those ‘protected sanctuaries’ and into the blood, they found. Therefore, infected cells in drug-sanctuaries within the lymphoid tissue can still produce new viruses  They can also infect new target cells and replenish the viral reservoir.

That’s why drugs have not been able to completely purge the body of latently infected cells – and kill the virus all together.

 

AIDS FACTS AND FIGURES 

AIDS-related deaths have dropped more than 40 percent since 2004 to 1.2 million a year, the report said. New HIV infections have fallen by 35 percent since 2001 to 2 million a year in 2014.

Investment in HIV/AIDS surged to almost $22 billion in 2015 from less than $5 billion in 2001.

One of the most remarkable successes has been reducing new infections among children by 58 percent between 2000 and 2014, the agency said.

 

The scientists utilized a mathematical model to track the amount of the virus and number of infected cells as they grew in the sanctuaries – and as they then moved through the body.

The model showed that HIV grows in areas where antiretroviral drug concentrations are lower than in the blood.

 

The scientists concluded that it is important to deliver high concentrations of antiretroviral drugs to all locations in the body where HIV may grow and evolve.

As such, drugs that penetrate these ‘newly discovered sanctuaries’ will be required to eliminate the viral reservoir – and may bring the medical community closer to finding a cure.

 

Co-author Dr Angela McLean, a professor of mathematical biology at Oxford University, said: ‘The study is exciting because it really changes how we think about what is happening in treated patients.

‘It helps explains why some strategies that tried to clear the reservoir have failed.’

The study was published in the journal Nature.

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