Aug 15, 2005
I'm on a first-line HAART regimen (Sustiva & Truvada) and have an undetectable VL (<50 copies / ml.). I'm wondering if simultaneously incorporating another drug class (or possibly several other drug classes) into my regimen (most specifically Fuzeon, or perhaps even a Protease Inhibitor) might increase the chances of possibly eradicating HIV from my body. Have any studies or clinical trials been attempted w/undetectable first-line HAART patients to see how such a blitz approach might work?
Response from Dr. Pierone
The notion of eradicating HIV infection by using more potent regimens has been debunked by kinetic studies of viral replication. The crux of the problem is that some HIV stays in a dormant state in long-lived cells and thus is not vulnerable to destruction by antiretroviral medications. This is why one tends to see viral rebound within days to weeks (sometimes months) after stopping HAART. This phenomenon of rebound occurs even in patients that have been treated with Mega-HAART regimens like you describe.
One idea that has been around for a long time is to attempt to activate and purge these infected cells of this dormant virus. Heat shock protein, IL2, and other cytokines have been discussed in this context, but progress in this field has been slow.
Another approach under study in your situation is to attempt a therapeutic vaccine and then stop HAART to see if the vaccine can help control viral rebound.
Thanks for posting and best of luck to you.
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