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HIV: A therapeutic advance for resource-limited settings

Second-line treatments of HIV infection recommended by the WHO for resource-limited countries are highly effective. However, there is currently no reliable way of de-escalating these treatments, while maintaining an undetectable viral load. Two strategies may provide a solution. The first is monotherapy with a boosted protease inhibitor (BPI), which in several trials has already yielded encouraging results, albeit with a risk of increased viral load. Such an increase constitutes a risk in resource-limited countries because patients there do not have access to regular virological monitoring, which can identify treatment failure. The second strategy is to combine a BPI with lamivudine, which is inexpensive, well tolerated, often used first line, and effective. This combination, however, has never been evaluated in patients infected by HIV with mutations that confer drug resistance, notably to lamivudine (M184V). ANRS 12286 MOBIDIP is the first trial to compare these two treatment de-e...
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Toward an hiv cure: Team develops test to detect hidden virus

Scientists at the University of Pittsburgh's Graduate School of Public Health announced in  Nature Medicine  that they've created a test sensitive enough to detect "hidden" HIV, and yet is faster, less labor-intensive and less expensive than the current "gold standard" test. The new Pitt test also revealed that the amount of virus lurking dormant in people who appear to be nearly cured of HIV is about 70-fold larger than previous estimates. "Globally there are substantial efforts to cure people of HIV by finding ways to eradicate this latent reservoir of virus that stubbornly persists in patients , despite our best therapies," said senior author Phalguni Gupta, Ph.D., professor and vice chair of Pitt Public Health's Department of Infectious Diseases and Microbiology. "But those efforts aren't going to progress if we don't have tests that are sensitive and practical enough to tell doctors if someone is truly cured." HIV...
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Understanding T cell activation could lead to new vaccines

Most current vaccines work by stimulating a class of white blood cells called B cells to make antibodies that circulate and control infections in the blood. For decades, scientists have been seeking a new type of vaccine that activates another player in the immune system called a T cell to fight off infections within different organs. A small number of a type of T cell, called memory T cells, are generated following an infection or immunization. Some memory T cells patrol the body looking for repeat infection, while others migrate into organs and remain there; these are called tissue-resident memory cells. These cells can be found where viruses and bacteria can get into the body, such as the skin, the gut and the female reproductive tract, as well as organs that are highly prone to injury, such as the brain. In a study a team of researchers, led by Aron E. Lukacher, chair and professor of microbiology and immunology, and Saumya Maru, a medical and doctoral student, has uncovered ...
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Reservoirs of latent HIV can grow despite effective therapy, study shows

"We knew before that the reservoir is very long lived," says Robert Siliciano, M.D., Ph.D., professor of medicine at the Johns Hopkins University School of Medicine, "but what we didn't know was how the reservoir was maintained. Now it is clear that these cells aren't just sitting there but are dividing and replenishing themselves." A report on the new research, published March 24 in the  Journal of Experimental Medicine , says resting CD4+ T cells not only make up the latent reservoir of HIV in those infected, but also have the potential to reactivate the production of active virus throughout the body. In the study, Siliciano and his team collected latently infected HIV cells from the blood of 12 patients with HIV on long-term antiretroviral therapy. After growing the CD4+ T cells in the laboratory, the investigators exposed them to four rounds of chemicals designed to stimulate cell division and proliferation. After each round of stimulation, th...
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Supportive housing improves health of formerly homeless people with HIV/AIDS

That conclusion seemed clear to Bowen, assistant professor in the University at Buffalo School of Social Work, during the four years she worked in a supportive housing program in Chicago, Illinois. Now as a UB researcher she has published a study that empirically supports what she experienced on the ground. "Supportive housing, a program of rental assistance and support services, is associated with improvements in the health outcomes of previously homeless people living with HIV/AIDS," she says. "Without stable housing it's hard to achieve these good health outcomes." The study, which appears in the journal  AIDS Care , relied on biometric data that predicts how effectively the body combats the virus. Prior to publishing their journal article, the team presented their preliminary findings at the 2016 International AIDS Conference in Durban, South Africa. Bowen and her coauthors examined two indicators of health: CD4 count, sometimes called T-cells, w...
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HIV status may affect the progression of HPV infection to cervical pre-cancer

In order to increase understanding of the way HPV infection progresses, and to compare its progression in HIV-negative and HIV-positive women, Whitham and colleagues analyzed data from six studies conducted from 1994 to 2010 in Senegal, where HIV is endemic. They followed 1,320 women for an average of two years, testing them for HPV and cervical abnormalities approximately every four months. At each clinic visit, women were characterized as normal, HPV-positive, or HSIL (HPV-positive with high-grade squamous intraepithelial lesions, a precancerous lesion that may progress to cervical cancer if untreated). The study showed that HIV-positive women had higher rates of acquiring HPV, and lower rates of clearing HPV infection, than HIV-negative women. Women whose immune systems were compromised by HIV were also more likely to have HPV infection progress to pre-cancer, the study indicated. For instance, HIV-positive women were 2.55 times more likely to have their HPV infection progres...
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Researchers uncover clues about how HIV virus mutates

To get at the question of how broadly neutralizing antibodies affect HIV mutation, evolutionary biologist Dr. Jesse Bloom teamed up with HIV researcher Dr. Julie Overbaugh and doctoral student Adam Dingens. The mutations they uncovered are a mix of those that had been discovered in previous studies as well as some newly discovered sites. Using a library of envelope, or Env, mutants made in a strain of HIV directly isolated from an infected child, the team infected T cells in the lab in the presence of PGT151. As the protein that covers HIV's surface, Env is the primary part of the virus that the immune system can see and act on. HIV is a particularly notorious foe for both the natural immune system and for immune reactions spurred by vaccines in part because Env mutates so rapidly, slipping away from immune recognition before the body can effectively rid itself of the infection. The researchers then sequenced the mutant viral strains that were able to infect cells in a petri ...
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