May 9, 2004
Since antiviral drugs have the ability to reduce the viral load to undetectable (below 50 copies), then why are we not able to go the "extra mile" to eradicate the virus from the body? Why can't we snuff out the virus completely? What will it take to accomplish that, and is that likely or possible in the near future?
Response from Dr. Pierone
The reason that we have not been able to eradicate HIV infection with current drug therapy has to do with the nature of this infection. HIV is an RNA virus that converts its RNA into DNA (by the enzyme reverse transcriptase) which becomes integrated into the human host cell DNA. This "Trojan Horse" element of HIV infection is one of the reasons that eradication efforts have failed thus far. How does one target a small snippet of non-replicating HIV DNA in a human lymphocyte or macrophage? Medications can shut down actively reproducing virus but do not address the dormant virus.
What it will take to accomplish eradication of HIV is not known. On idea is to develop a gene therapy treatment that would gum up the cellular triggers that enable the HIV DNA to activate and transform the infected lymphocyte into an HIV production factory. A "magic bullet" targeting this chronic and largely silent aspect of HIV infection will be central to developing a cure. Are we close? Unfortunately, I don't think we are.
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