Some hopeful possibilities in the far future

Adapted from http://www.thebody.com/

It feels like every few months, some research team or another announces the discovery of a new way to potentially eradicate HIV. So press releases such as the one below from Vaccine & Gene Therapy Institute (VGTI) Florida must always be taken with a grain of salt. However, this new development in the HIV treatment field appears worth getting at least a little perked up about.

The focus of this new research is a group of immune cells called "memory T cells." It's believed that these cells are harboring "latent" forms of HIV -- HIV that manages to lie dormant within the body, hidden away from HIV medications that flow through the bloodstream. If a person stops taking HIV meds, this reservoir of hidden HIV springs back into action and the virus spreads anew, the theory goes.

Enter a team of VGTI Florida and University of Montreal researchers. They believe they've actually been able to pinpoint the specific types of memory T cells in which HIV is hiding -- and, even better, they think they've figured out how those HIV-infected memory T cells stay alive. Armed with this information, they hope they can develop a new type of HIV treatment that attacks HIV-infected memory T cells at the same time that existing HIV meds attack other HIV-infected cells. "We believe that by attacking the disease in these distinct two ways at once for an extended period of time, we can eliminate the reservoirs of HIV that currently persist within the human body, leaving an individual disease-free," says Rafick-Pierre Sékaly, Ph.D., the scientific director of VGTI Florida and former researcher at the University of Montreal.

Pretty dramatic words, no? Whether this is truly something to get excited about remains to be seen: The researchers need to test their theory in animal studies before they can even begin to see whether this approach will work in humans. But it's another sign of slow progress in a field that has long felt stagnant, and hopefully each new tidbit we learn about how HIV works will indeed bring us closer to the day we can find a cure.

You can read the full press release from VGTI Florida here:

VGTI Florida, University of Montreal Researchers Uncover Approach for Possibly Eradicating HIV Infection
From VGTI Florida
St. Lucie, FL -- Researchers from the newly-established VGTI Florida and the University of Montreal have uncovered a possible method for eradicating HIV infection in the human body. The researchers have also revealed new information which demonstrates how HIV persists in the body -- even in patients receiving drug treatments -- and how the virus continues to replicate itself in individuals undergoing treatment.

Medical advancements in the past 20 years have significantly increased the survival rates of AIDS patients. In fact, approximately 90 percent of patients infected with AIDS can survive with the disease as long as they are treated with a complex series of antiretroviral drugs.

"Current medications allow us to control HIV and limit its progression in most cases. However, the medications do not eradicate the disease. Instead, the disease persists within the body -- much like water in a reservoir - and is never fully destroyed. We believe our latest research may help scientists and physicians overcome this hurdle."

The research team was able to identify a possible new way of attacking HIV by first identifying the specific cells where HIV infection persists in patients currently undergoing treatment.
They found that the disease is able to survive within two subsets of memory T-cells. Memory T-cells are a portion of the body's immune system and have the ability to learn, detect and attack certain types of infectious diseases. By infecting cells within the body's own immune system, HIV is able to avoid antiviral treatments that are effective in stopping HIV in other cell types in the body. In-effect, HIV uses the body's own defense system as a hideout.

The research team was also successful in identifying how these HIV-infected memory T-cells replenish themselves. When populating T-cells, HIV does not replicate itself as it does in other cell types on the body. Instead, HIV persists in memory T-cells through cell division -- a finding that holds significant implications for possibly stopping the disease.

"Based on this research, we believe one possible method for eliminating HIV in the body is to use a combined approach," said Dr. Sékaly. "We propose the use of medications that target viral replication of HIV throughout the body, in combination with drugs that prevent infected memory T-cells from dividing. We believe that we can eliminate the reservoirs of HIV that currently persist within the human body, leaving an individual disease-free. While this is a preliminary finding, we are hopeful that this research discovery will guide us in eradicating HIV infection in the body."

HIV and Aging - June 24, 2009

Over the past few years there has been more attention paid to the possibility of aging and being HIV+ at the same time. That was originally seen as a non-sequitor since the diagnosis of infection with HIV was equated with a considerably shortened life span. In the last ten years of Anti Retroviral Therapy [ART], that truism has changed and people with HIV keeping a “healthy” lifestyle and being on ART are advised that they can live pretty much a “normal” lifespan.

Of course, this is our first go round at this disease and as conditions change and people are living longer; new information is constantly being discovered, keeping the need for an open mind about this disease and its accepted truths as paramount.

Concepts and details about longevity are no exception.

Now we go to observe longevity at a cellular level, at the T-cell or immune cell level, to be exact.

Every cell contains a tiny cellular clock called a telomere, which shortens each time the cell splits in two. Located at the end of the cell’s chromosome, the telomere limits the number of times a cell can divide. Immune cells that fight HIV are under constant strain to divide in order to continue performing their protective functions. This massive amount of division shortens these cells’ telomeres prematurely, explains Dr. Rita Effros, Plott Chair in Gerontology, David Geffin School of Medicine at UCLA. So the telomeres of a 40-year-old person infected with HIV resemble those of a healthy 90-year-old person.

In common parlance, immune cells that battle HIV must constantly divide in order to continue performing their protective functions. The massive amount of division required to defend against the constant invasion of HIV cells prematurely shortens these cells' ends, or telomeres; ultimately exhausting the immune system. So the immune system of a person with HIV is rendered prematurely old, something that has been intuitively suspected but has never confirmed scientifically until now.

The good news is that this process of CD4 and CD8 [immune cells] senescence was originally found to be slowed down by invasive genetic work. But now, though the use of TAT2, a naturally occurring substance in the Chinese herb, astrulagus; the same positive result can be achieved. This work is still in early phases but offers hope for a natural therapy, different in impact from the many current HIV medicines and their often toxic side effects

Dr. Effros currently is examining the role of exercise, nutrition and caloric intake on the immune system's ability to function effectively. All are seen to impact this process a great deal, as does smoking cigarettes; emphasizing yet again the importance of considered daily health and lifestyle choices for us all.

Canadian Public Health Association 2009 Conference, Winnipeg, Manitoba, June 6 – 10, 2009

I attended the Canadian Public Health Association 2009 Conference [ a fifteen minute walk from the Manitoba Legislature] motivated by my belief that HIV /AIDS information and issues, including the related Social Determinants of Health [ such as housing, poverty, addiction and mental illness, all of which feature greatly in other diseases such as Hepatitis C, tuberculosis, diabetes and N1H1 to mention a few] would benefit from a broader discussion. Another reason I had was to find out what the range of the discussion on HIV is in the broader community.

In brief, there is little awareness or discussion. There were 260 plenaries and presentations / discussions at this large conference. Of these, only two had “HIV” in the title. On a related note, which Hepatitis C also related to the ‘poverty’ determinants of health, garnered little more attention.

I raised questions and ethics issues in one plenary and in all the presentations that I attended. I was heard and hope that the ideas stick in the brains of a few listeners.

To be fair, it is a public health conference and issues affecting the public at large such as: child health and development, chronic disease , First Nations, health inequalities and inequities, infectious disease, mental health and illness; dominated especially H1N1 which was in the news the week of the conference due to a large outbreak on several First Nations reserves in Northern Manitoba. In addition issues like urban/rural service disparities and integration between municipal, provincial and federal health services and jurisdictions. However, in my opinion, several topic areas begged fro the inclusion of HIV such as chronic disease, First Nations, health inequalities and inequities, infectious disease, and mental health and illness. Even in the presentations that focused on First Nations, HIV was not significantly present.

HIV – the disease of the marginalized, the modern day lepers, is marginalized. What is not acknowledged or seen, must not exist