Posted on 02/14/2008 10:07:27 PM PST by neverdem
Even the best drugs currently available cannot weed out HIV from all of its hiding places within the body, according to a new study of HIV patients in the United States. The discovery seems to confirm doctors' suspicions that once the virus gains a foothold, it can never be fully eradicated from the body.
After years of aggressive drug treatment, the virus still hides out in significant reservoirs, particularly in tissues surrounding the gut lining, the researchers report. Cells in these tissues, a part of the immune system called 'gut-associated lymphoid tissue', remain infected with the virus even though the patient may be leading an apparently healthy life.
Many HIV patients can manage their infection with a cocktail of drugs called antiretroviral therapies (ARTs). These can reduce their 'viral load' — the amount of virus circulating in the blood plasma — to undetectable levels.
But the new study shows that even in such 'non-infectious' patients the virus is still lurking in gut tissues, and still infecting other immune cells in the blood.
"It might not ever be possible to completely eradicate the virus from the body, even though people are doing well," says Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases in Bethesda, Maryland, who led the research. He adds, however, that this doesn't mean that patients will be more likely than previously thought to pass on the virus to others.
Incurable
The finding underlines HIV's status as an 'incurable' infection, although in many cases doctors are able to stave off the onset of full-blown AIDS by giving patients sustained courses of drugs.
Indeed, so effective are current drugs that most say HIV should now be seen as a chronic disease requiring lifelong management, in the same way as diabetes or chronic hypertension. "It's not a death sentence," says Deenan Pillay of University College London, an expert on antiviral treatments.
Earlier this month, the Swiss National AIDS Commission broke with convention by declaring that HIV-positive patients who had had successful antiretroviral treatment could be declared 'non-infectious' through sex. Other health agencies still maintain that the only safe way to prevent HIV transmission is to practice safe sex, particularly by using a condom.
The new results show that even state-of-the-art drugs cannot stop HIV replicating in certain body tissues, Pillay says. "We have always known that current paradigms of treatment are not sufficient. If anything, this demonstrates that there's even further to go."
Fauci and his colleagues studied eight HIV patients, who had been taking ART drugs for several years, and in one case nearly a decade. All were in good health with low blood plasma levels of the virus. But when the researchers took biopsies of their gut lymphoid tissue, they found that HIV was still present, and levels of CD4+ cells — the cells targeted by the virus — were lower than normal.
The researchers also compared DNA from HIV found in the gut with DNA from HIV found in white blood cells , and found that they were very similar, indicating that the two tissues constantly re-infect one another as the virus replicates; the gut reservoir is not isolated from the rest of the body. The results are published in the Journal of Infectious Diseases.
Stamped down early
Pillay argues that HIV tests should be given to more patients who show the flu-like symptoms of early infection, in a bid to identify more people who have only just been exposed to the virus. Because the virus colonizes the gut tissues early in infection, rapid intervention may help to reduce the size of this viral reservoir. That could in turn make it easier to keep blood plasma viral loads low during the course of the disease.
Last year, Britain's chief medical officer Liam Donaldson wrote to doctors, urging them to test more widely for the virus. "There's a push to get wider testing, and I'm personally very much in favour of it," Pillay says.
Reducing viral reservoirs by early intervention could particularly help patients without access to top-of-the-range drug treatments, Pillay suggests.
G-A-Y = Got Aids Yet?
I got it—stomach transplants!!!—Force citizens of New Jersey to supply the bellies...
Being a retrovirus, it doesn’t need to hide in the gut. It can clone itself right into the cells DNA.
The movie Andromeda Strain comes to mind.
I agree. Are they so consumed by their twisted lust that the obvious escapes them? What fools.
More reason to wait until you’ve at least met a great girl, and have been dating her for a while, until you have sex.
Excellant.
I never thought that it could be eradicated I always assumed it just went dormant with treatment.
Well, that will require the same compliance on both sides... the girl is a vector, too.
This is incredibly irresponsible. These people (and anyone they influence in this regard) will be the cause of many needless deaths.
Longtime Christians will probably ostracize me, but my view on premarital sex is that as long as you’re both deeply in love, I see nothing wrong with it. I know it’s having sex outside of marriage, but if you’re considering spending the rest of your life with the girl, then there’s no problem as far as I’m concerned.
Just my $0.02
If I feel like I’m not ready to take a relationship a step further, but my (future) girlfriend is, I’ll let her know that I’m not ready, and I’d hope she would respect my decision.
If she can’t, then I still would be saving myself.
Not trying to save myself but at least I don’t go around having sex with random women.
The solution to HIV and Global Warming are the same... Eradicate humanity. Problem solved. /sarc
No, not like that.
What I meant was, for minimal chances of contracting STD’s, the woman shouldn’t have an, ahem, “colourful” history, either.
Your chances of getting HIV from normal, heterosexual activity with individuals who are not in a high-risk group is close to zero.
Personally I would be more worried about herpes. It is incurable and extremely common. It won't kill you but you'll have to deal with outbreaks for the rest of your life. Not worth it.
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