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Recognizing the virus
Oct 14, 2003

Dear Dr.,

I am not an expert. Though I do study microbiology, the particular area of viruses is not my field. However, I was talking to a colleague the other day and he is an "expert" who told me about the intense research into fusion and/or entry inhibitors, particularly in the USA. He said they will be the treatment option of choice in years to come. Now he was also saying that after some time on HAART studies are suggesting the infected cells are being cleared of the virus, which is virtually shut down, as well as showing that the CD4s can rebound even when at catastrophic depths (more than we can say for glial cells) and without resistance this efficacy will continue indefinately.

I thought the drop in VL after 3 weeks of treatment was due to the amount in the bloodstream. He said that is part of it but the tissues are where most of the replication takes place, where the nukes do most of their work. That is scientists took pieces of infected lymph tissues indeed the VL would be very detectable. What I was asking was if we can prevent entry and integration of the virus with drugs AND use some type of immunological marker, than isn't it plausible to clear the cells from the body? Surely these 'sanctuary' sites are the first place the virus makes home and the last place it will leave. I was told this is an area under investigation and the focus is now on keeping the virus down for the count, of which has been possible in only ten years time.

Thanks Dr. Young Keep up the good work and the great attitude!

Response from Dr. Young

Thanks for your question(s) and comments.

I agree that entry and fusion inhibitors are very exciting aspect to future strategies to treat HIV. There is much more than just stopping the virus in having an effective, long-term HIV treatment, never mind an eradicative therapy-- so much so, that I would hesitate to bet on what role the current batch of entry and fusion inhibitors will play.

Stay tuned, though, I know that the pipeline is robust and will deliver a lot of new data. BY



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