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03.15.2013

adults cured of HIV

HIV Medications

A new report in PLoS Pathogens reports that in 14 adults are have been functionally cured of HIV. This comes after a Mississippi baby was miraculously cured of HIV because of early treatment. Early antiretroviral treatment seems to be important in these cases as well. From a summary in The New Scientist:

Asier Sáez-Cirión of the Pasteur Institute’s unit for regulation of retroviral infections in Paris analysed 70 people with HIV who had been treated with antiretroviral drugs (ARVs) between 35 days and 10 weeks after infection – much sooner than people are normally treated.

All of the participants’ drug regimes had been interrupted for one reason or another. For example, some people had made a personal choice to stop taking the drugs, others had been part of a trial of different drug protocols.

Most of the 70 people relapsed when their treatment was interrupted, with the virus rebounding rapidly to pre-treatment levels. But 14 of them – four women and 10 men – were able to stay off of ARVs without relapsing, having taken the drugs for an average of three years.

The 14 adults still have traces of HIV in their blood, but at such low levels that their body can naturally keep it in check without drugs.

The 14 adults are not naturally resistant to HIV infection and are not currently taking any medication to control their HIV.

03.15.2013

CD4 cells are instrumental in controlling HIV infection

HIV medication

A report in Science discusses how a subset of CD4 cells could prevent HIV from destroying the immune system:

HIV preferentially invades T lymphocytes that have CD4 receptors on their surfaces. The resulting destruction of CD4 cells over a decade or so cripples the immune system and is the hallmark of AIDS. But the process takes many years because the central memory cell, a type of CD4+ T lymphocyte known in shorthand as Tcm, churns out clones of itself and can almost refill the body’s pool of CD4 cells as fast as HIV drains it. However, the downside is that some infected Tcm cells become reservoirs of latent virus that rekindle infection if antiretrovirals (ARVs) are stopped.

The report is based on a series of studies of HIV patients. In the first study 75 HIV patients were split into three different groups and received antiretroviral medications within 5 days of taking a blood test. When their blood was analyzed 24 weeks later, the level of HIV-infected Tcm cells was almost extremely low or undetectable. In another study researchers looked at why some patients were better able to protect their CD4+ cells without antiretroviral treatment:

The study compared nearly 300 infected people who had low levels of HIV in their blood, two-thirds of whom received treatment. The researchers found that elite controllers stood out in part because their Tcm cells downregulated a key receptor that HIV needs for entry and were less permissive to HIV infection. Conversely, Kitchen noted that people whose immune systems did not rebound even though ARVs controlled their infections had Tcm cells with impaired function.

Check the source link for more.

03.04.2013

baby cured of HIV

HIV medications

A baby, born in Mississippi 2.5 years ago appears to have been cured of HIV, the virus that causes AIDS. She is the first child, and only the second person ever, to have been thought to be cured of the infection. The cure was acheived thanks to an aggressive and early treatment with antiretroviral drugs just 30 hours after she was born. From NPR:

Gay decided to begin treating the child immediately, with the first dose of antivirals given within 31 hours of birth. That’s faster than most infants born with HIV get treated, and specialists think it’s one important factor in the child’s cure.

In addition, Gay gave higher-than-usual, “therapeutic” doses of three powerful HIV drugs rather than the “prophylactic” doses usually given in these circumstances.

Over the months, the baby thrived, and standard tests could detect no virus in her blood, which is the normal result from antiviral treatment.

Doctors then lost track of the baby for several months, as the mother went through “life changes.” But when they regained contact with the child, it showed a surprising lack of HIV virus. Again from NPR:

Gay expected to find that the child’s blood was teeming with HIV. But to her astonishment, tests couldn’t find any virus.

“My first thought was, ‘Oh, my goodness, I’ve been treating a child who’s not actually infected,’ ” Gay says. But a look at the earlier blood work confirmed the child had been infected with HIV at birth. So Gay then thought the lab must have made a mistake with the new blood samples. So she ran those tests again.

The results of this isolated event are prompting researchers to begin planning studies on whether this early and aggressive treatment can be more widely applied. It would have huge implications for AIDS treatment in the developing world where many children are infected with HIV during birth.

Also see coverage at the New York Times.

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