We should do something cutting edge.
Let's go for the whole thing.
Now that effective combination antiretroviral therapy has restored health and extended lives for many people with HIV, researchers and advocates are again turning their attention to a cure.
On February 4, the AIDS Policy Project, in conjunction with Project Inform, held its first scientific update on HIV eradication, bringing together local experts to provide an overview of an exclusive conference held this past December on the Caribbean island of St. Martin.
"Current drugs are not a panacea," said Matt Sharp, Project Inform's director of treatment and prevention advocacy, who has survived on them for two decades. "Antiretroviral therapy has made HIV a chronic manageable disease, but it's still not a cure."
While treatment has dramatically reduced illness and death from opportunistic infections due to immune system collapse, a growing body of evidence shows that even low-level HIV replication can wreak havoc throughout the body, perhaps by triggering chronic inflammation. This may explain higher rates of non-AIDS problems such as heart and liver disease in HIV-positive people, as well as what looks like accelerated aging.
Today's potent regimens can knock HIV in the blood down to an "undetectable" level in most people who achieve good adherence, but ultra-sensitive tests reveal that a small amount remains behind.
HIV inserts its genetic material into the DNA of latent or inactive T-cells, and there it remains until the cell is activated. Today's drugs can fight virus in the blood, but not sequestered in latent cells. The trick, therefore, is to "wake up" these reservoir cells, causing them to release virus and making them visible to the immune system.
The 4th International Workshop on HIV Persistence during Therapy brought together a small group of researchers from academia, government, and the pharmaceutical industry, along with community treatment advocates, to discuss the current state of eradication research.
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