July 22, 2010
Vienna, Austria -- At the XVIII International AIDS Conference, researchers discussed the need to create safer and more effective treatments for the virus than have existed before. The conference offered insight into the areas which offer some for the best promise for future prevention, treatment and cure efforts. Here are some examples of what experts were talking about.
When developed functional cures will offer HIV-positive people long-term health without taking antiretroviral (ARV) treatment by OKAY, SO HOW DOES IT WORK?
In WHEN a German leukemia specialist Gero Huetter, M.D., replaced the bone-marrow cells of an HIV-positive cancer patient now known in scientific circles as the Berlin Patient, with stem cells, cells without a specific identity that can potentially turn into any type of cell. The stem cells in question came from a donor patient who has a genetic mutation that prevents them catching HIV, the virus that causes AIDS. The stem-cell transplant was carried out to treat the leukemia, but a side-effect of the treatment was the destruction of HIV cells, making the Berlin Patient essentially immune to HIV and allowing him or her to stop taking HIV/AIDS medication. The stem cell recipient hasn't taken drugs for over two years since receiving the transplant. This groundbreaking result opened the doors to treatments that could possibly make prevent infection and eliminate the need for medication among those who are already infected.
This breakthrough is very new and so monumental that scientists are still exploring the many possibilities and therapies that might be employed.
Bone marrow transplants are very dangerous so the therapy the Berlin Patient received is unethical unless the patient requires an organ transplant because of another illness. However, the concept behind this discovery could open up new avenues of research, as scientists work towards finding a way to cure HIV.
Rare sets of genes allow the immune systems of a small percentarge of people to unleash killer T cells -- parts of the immune system that attack invading TKTK -- with unusual powers that allow them to attack and destroy HIV cells. These people who have these genes are HIV positive, yet the virus does not progress to AIDS and their symptoms do not worsen.
A study from the University of Southern California found that mice with a mutation in a specific gene have immunity to HIV. Since then researchers have identified similar gene mutations in humans.
Because stem cells reproduce indefinitely, these mutant stem cells could provide a permanent supply of HIV-resistant immune cells. Certain people whose cells are able to effectively attack and destroy HIV may never experience symptoms even though they are infected with the virus.
Because the gene mutation does not provide HIV immunity in all populations, researchers are looking at other more common proteins, found in everyone, that may bestow a natural advantage in fighting off the virus. Further understanding of these mechanisms could assist in the development of vaccines that augment control of infection, and may also serve to identify new targets for pharmacologic intervention.
Medical studies are being performed to ensure that possible treatments for HIV/AIDS will work. Some existing prescription drugs currently used for other treatments are being tested as possible HIV/AIDS therapies and treatments.
A drug approved to treat lymphoma, Zolinza, targets specific proteins in cancer cells and stops the cancer cells from growing. It is used to treat certain cancers including T-cell lymphoma. Researchers believe that this same action can destroy the HIV virus.
Awakens dormant T-cells in HIV-positive people to potentially make those cells vulnerable to antiretroviral (ARV) medication.
Researchers are exploring the treatment in people on ARV therapy. So far, scientists have experimented with several different drugs in attempt to wake up dormant infected cells, but the compounds used were either ineffective or too toxic.
Scientists hope that in the future people will be able to prevent HIV infection, and possibly STDs, by applying gel to the vagina or rectum before or after sex.
The biggest breakthrough at the conference involved a South African clinical study of roughly 900 Black South African women who tested an HIV-microbicide gel. Half of the women used a tampon-like applicator to insert the retroviral drug tenofovir (prescribed in pill form as Viread) into the vagina 12 hours before and 12 hours after sex; the other half inserted a harmless and inactive placebo gel. Results showed that the gel with tenofovir reduced HIV incidence by up to 54 percent.
Additional trials will examine the microbicide's effectiveness in a larger group of women, as well as its effectiveness in rectal use. Researchers also have to determine why the gel becomes less effective against HIV after 18 months of use.
Experts increasingly understand that an HIV-positive person's nutrition strongly influences their survival rates and quality of life. Not only do nutritional deficiencies exist among people without HIV, nutritional deficiencies may occur at any stage of disease and can impair immune response, accelerate the progression of the disease, increase the frequency and severity of opportunistic infections and impede the effectiveness of medications.
Some of the most interesting research involves vitamin D. Study investigators from Switzerland analyzed 211 HIV-positive patients to determine their vitamin D levels in the spring and the fall, resulting in the highest and lowest vitamin D levels in their bodies. In HIV-infected patients, vitamin D supplementation was shown to improve T-cell counts and lower death rates from HIV.
Vitamin D is involved in hundreds of body processes. Its absence can result disrupt many vital process leading to a wide variety of conditions and diseases, ranging from depression to breast cancer to diabetes and high blood pressure.
The study investigators recommend that all HIV-positive patients routinely be screened for vitamin-D deficiency and receive an adequate supply to reduce their risk for adverse outcomes.
Vaccines help activate the body's antibody system to protect it against invading germs and viruses. HIV-vaccine protoypes would theoretically prevent people from being HIV-infected.
An Army-sponsored phase III clinical trial involving more showed that an investigational HIV vaccine regimen called RV144 was safe and modestly effective in preventing HIV infection.
The vaccine combination was based on HIV strains that commonly circulate in Thailand. While the efficacy was modest, this study represents a significant scientific achievement.
With this evidence that a safe and effective HIV vaccine is possible, and the results should accelerate research efforts towards a more effective vaccine.
With the toxicity of the present HIV/AIDS drugs, persistent HIV and inflammation, and aging, all contributing to increasing levels of cardiovascular disease, metabolic disorders, neurocognitive abnormalities, liver and renal disease, bone disorders, malignancy and frailty.
At this year's Conference, the promise for advances in research and treatment offered exciting hope for the future of a world impacted by the insidious nature of the HIV virus.
Glenn Ellis, author of Which Doctor? What You Need to Know to Be Healthy, is a Philadelphia-based health columnist and radio commentator.