New Clues to How Long-Term Drug

Therapy Keeps HIV at Bay

November 26, 2013

By Randy Dotinga

HealthDay Reporter

TUESDAY, Nov. 26, 2013 (HealthDay News) A new study suggests that the replication
of HIV may slow or stop altogether in patients who are on long-term treatment, although
remnants can still lurk in the body.

And the researchers now suspect that the virus is especially weak in those people who
started treatment immediately after becoming infected.

The study is very small, involving just eight patients. However, the findings add more
evidence to the debate over how soon patients should begin drug treatment after theyre
diagnosed as being infected with HIV. One of the study authors is ready to say that
treatment must begin immediately.

Patients should be started on therapy as soon as they are diagnosed to prevent the virus
from hiding in large numbers of cells, said the researcher, Sarah Palmer, deputy director of
the Center for Virus Research at Westmead Millennium Institute for Medical Research, in
Australia. Diagnosing HIV infection early and initiating therapy immediately is crucial for
limiting the number of cells containing HIV.

While doctors can use drugs to kill the AIDS virus in the body, its impossible to eliminate
it completely. That means theres no cure for HIV infection or AIDS, the potentially deadly
condition that the virus causes.

But what does the virus do when a patient is on medication does it keep replicating
[making copies of itself] or does it hide? The authors of the new study sought to find an
answer by analyzing immune-system cells taken from eight HIV-infected patients. All had
been taking anti-HIV drug treatment for years.

This combined drug treatment is known as antiretroviral therapy (ART).

The researchers analyzed the cells and found that drug treatment appeared to stop the virus
from replicating an important finding that suggests a possible weakness. However, HIV
didnt vanish but instead hid in certain types of immune-system cells known as resting
memory T cells. These cells remember how to fight a particular body invader, such as a
germ or virus and sit around waiting for it to return.

These cells can remain dormant for many years even though they are carrying HIV,
Palmer said. When these cells start to replicate or are stimulated to replicate as part of our
normal immune response, they also produce HIV, keeping the virus viable. Essentially,
these cells are a ticking time bomb in patients, and once they are ignited they explosively
produce HIV.
This finding confirms previous research showing that the lurking virus is very stable for
years, said David Schaffer, director of the Berkeley Stem Cell Center at the University of
California, Berkeley. It means that treatments must be developed to directly eliminate this
long-lived pool, which is challenging, said Schaffer, who is familiar with the studys
findings.

However, theres some good news. The numbers of these cells were smaller in patients who
had started treatment soon after being diagnosed instead of waiting until they began to
show symptoms.

Diagnosing HIV infection early and initiating therapy immediately is crucial for limiting
the number of cells containing HIV, Palmer said. The scientific community must develop
better strategies to flush HIV from its hiding place in patients without causing new
infections.

Schaffer agreed. A treatment cant just halt the virus from growing in the body and wait for
the infected cells the latent pool to die out, he said. Finding a cure for HIV means
that therapies must be developed to directly eliminate the latent pool of virus.

The study will appear online in this weeks issue of the Proceedings of the National
Academy of Sciences.

http://news.health.com/2013/11/26/new-clues-to-how-long-term-drug-therapy-keeps-hiv-at-
bay/