April 17, 2015
This week we look at an intriguing case study of an elite controller that speaks to the power of the immune system, and a couple of thought-provoking commentaries on the prospects of an HIV cure and vaccine. Those stories and more in a selection of highlights and under-the-radar developments we collected this week to help you stay informed. To beat HIV, we have to follow the science!
A long-term nonprogressor living with HIV and myeloma (a cancer of the bone marrow) was able to control HIV that had reawakened after he underwent a stem cell transplant to treat his myeloma. Without antiretroviral treatment, the patient's immune system alone was able to accomplish this.
For reference, a long-term nonprogressor, or elite controller, is a person living with HIV who is able to control the virus and persistently keep low viral loads, all on their own without the aid of antiretroviral therapy.
When will we discover an HIV cure and vaccine? Earlier this year, Bill Gates predicted it would take 15 years. Richard Jefferys of Treatment Action Group discusses whether this optimism is realistic, where we currently are in the science, and what we can reasonably expect.
"A true long-term solution to HIV infection merits an appreciation of alternative ideas and findings that could be beneficial in the ultimate control of HIV/AIDS," writes Jay A. Levy, M.D. Here are the six key questions Levy urges HIV researchers to keep in mind when investigating and designing new trials.
As more research indicates that people living with HIV are more likely to experience cardiovascular disease (CVD), and up to twice as likely to have a heart attack, even after accounting for traditional risk factors, the focus shifts to reducing HIV-related CVD. The Randomized Trial to Prevent Vascular Events in HIV (REPRIEVE) has begun recruiting participants "to test whether statin administration can reduce the risk for major cardiovascular events, such as heart attacks, strokes, and heart disease, in people with HIV infection."
A recent study followed 1,229 people living with HIV and randomized them into two groups to receive either care with enhanced personal contact from clinicians along with basic HIV education, or the current standard of care. About 46% of those in standard of care were retained in care. On the other hand, about 56% of the intervention group were retained in care, making it about 22% more effective than standard of care. Additionally, the intervention strategy was estimated to generate $24,000 in extra profit for a clinic of average size.
For patients with CD4+ counts above 250 and an undetectable viral load, just one CD4 count test a year may be enough, according to a recent study published in the Journal of Acquired Immune Deficiency Syndromes. Researchers found that for individuals doing well on treatment, the risk of experiencing serious HIV-related illnesses or having their CD4 counts drop below 200 is very low.
This week, the Centers for Medicare and Medicaid Services expanded coverage to include one, annual voluntary HIV test for all Medicare beneficiaries between the ages of 15 and 65, regardless of risk.
Biologists at San Diego State University have developed a method for discovering drugs that can interrupt a virus's proliferation, a process in dengue virus known as premembrane protein (prM) cleavage. Using this method, the researchers were able to find a potential new drug to combat dengue virus and are hopeful they can apply this robust platform to other viruses, such as HIV.
Viruses, including HIV, mutate constantly in order to adapt to our bodies' defenses and live on. It's the main reason why HIV continues to escape eradication. However, scientists are finding ways to turn this strength against viruses. The strategy, known as lethal mutagenesis, seeks to force viruses to mutate past their own mutation threshold to the point where they can no longer maintain their genetic material.
Is there a development this week in HIV research that you think we missed? Send us a tip!
Warren Tong is the senior science editor for TheBody.com and TheBodyPRO.com.
Follow Warren on Twitter: @WarrenAtTheBody.
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