HIV Takes a Beating

According to the Center for Disease Control (CDC), the HIV virus first appeared on the scene in 1981. This virus which has been around for at least 33 years used to be a death sentence, but the advance in drug-therapies has been so great that it is no longer considered as such. This has been good news for the medical community and the world. Recently, there is even better news. New developments are going to take the virus by storm, either by eradicating it altogether in infancy, or by beating it back in adult patients, so that the need for today’s drug-cocktails is greatly reduced or even eliminated.

Three years ago it was reported that a Mississippi baby had been cured of the virus when it was given antiretroviral drugs in the first hours of its life. Although doctors involved in the case felt certain of what had happened, the news was received mainly with skepticism. Infected mothers have specific neonatal care to prevent the virus from passing to the baby. Because the mother in the Mississippi case had not even been aware she herself had HIV, the necessary neonatal care had not been administered. The baby was transferred to the University of Mississippi Medical Center, where an aggressive mix of antiretroviral drugs was given. The baby continued to receive the cocktail until the age of 18-months, when the mother stopped seeing doctors. Five months later when the mother took her child back, doctors were certain the child would still be infected, but the virus, if ever there, was beaten. The child has been considered HIV-free since, but not many in the medical community were convinced.

On March 5 at an AIDS conference in Boston the existence of another such case was announced. A baby born in Long Beach, California, had been indisputably HIV-positive, with viral DNA and RNA in both the blood and the spinal fluid. A viral specialist from the Johns Hopkins Children’s Center, Dr. Deborah Persaud, has been involved in both cases. The proof that the HIV was both there and is now gone nine months later in the baby from Long Beach is irrefutable. Dr. Persaud was conservative in how she described the present case, saying as this child is still being treated, it cannot be said it is yet cured, but is described as being “sero-reverted to HIV-negative.”

Because of these two cases and another few similar ones in Canada and South Africa, a trial is planned to begin in three months with 50 newborns who will be administered an aggressive mix of the antiretroviral drugs, a dose not formerly recommended for newborns and a treatment rather than a prevention dose. These children will be followed for several years. If all goes well there will be a new way of treating the three hundred thousand plus babies born around the world every year with the virus.

Beating back this tricky virus has also taken a turn for the better among adult patients with HIV. The new procedure of implanting a person’s own genetically altered immune cells into their body is being studied and shows promise.

The main target of the virus in the human body is an immune cell called a CD4 cell. It was already known that a receptor called CCR5 made the CD4 cells vulnerable, and people without this receptor are immune to the virus. Sangamo BioSciences in Richmond, CA, have developed a way to block this receptor in CD4 cells using an agent now called the Sangamo agent. The study, which began five years ago, has scientists extracting CD4 cells from participants and “reprogramming” them with the agent so that they will not be as susceptible to the HIV virus. Further and more extensive studies must be carried out, as this study only used 12 patients. However, initial results are hopeful. Patients are able to go several months with much smaller doses of the antiretroviral drugs, and in some cases have gone without for a time. The HIV virus is suppressed, not beaten, and takes a backseat. Patients may be able to live drug-free with the virus in the future, merely by continuous drug reprogramming.

By Julie Mahfood
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New York Times
San Francisco Gate

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