Top HIV News of 2017

#5: MRI Scans Can Help Identify HIV Persistence in the Brain After Treatment

With 36.7 million individuals across the globe living with HIV, researchers everywhere are seeking to better understand the virus in the hopes of findings ways to control it and ultimately cure those who are infected. Many of the methods used to learn more about the virus can be invasive for the patients; however, new research from the University College London (UCL) has provided another piece to the puzzle that is HIV, with minimal invasion on the patient.

Published in the journal Clinical Infectious Diseases, the new study shows that UCL scientists have found a way to use MRI scans to detect when HIV persists in the brain “despite effective drug treatment,” according to a recent press release.

Senior author Ravindra K. Gupta, professor of infection and immunity at UCL, honorary consultant in Infectious Diseases at The Hospital for Tropical Diseases, UCLH NHS Foundation Trust, explained the significance of detecting HIV in the brain, “Before we had effective treatments for HIV, AIDS often led to dementia and other problems in the brain.”

Read more about how MRI scans can help identify HIV persistence in the brain after treatment, here.

#4: Herpes Simplex Virus 2 and HIV—What's the Connection?

Although international health organizations often focus on the nearly 37 million people worldwide who live with HIV, another sexually transmitted disease—herpes simplex 2 (HSV-2), the main cause of genital herpes, is a far more common condition. According to the World Health Organization, as of 2012, there were 417 million people globally between the ages of 15 and 49 with HSV-2, many of them, like most with HIV, reside in sub-Saharan Africa. And while HSV-2 on its own is not fatal, having the condition makes an individual more likely to contract HIV, just as having HIV raises a person’s risk of HSV-2.

This symbiosis and what it means for a vulnerable population was behind a British team’s effort to document the risk of HIV acquisition in people infected with HSV-2. Scientists at the University of Bristol and Imperial College London delved into multiple studies conducted between 2003 and 2017, mostly in Africa, that examined the connection between these 2 chronic infections. They found that individuals with HSV-2 had a decidedly higher risk of acquiring HIV than those without HSV-2. This risk was nearly tripled among the general population and doubled for people in high-risk categories, such as women engaged in sex work, men who frequent sex workers, and men who have sex with men. And when the data was analyzed to separate out individuals who had acquired HSV-2 after the study began versus those who had been infected with it earlier, the team found that the risk of contracting HIV was 5 times greater in the general population.

Continue reading about the connection between HIV and HSV-2, here.

#3: Reservoirs of Latent HIV Hinder Quest for a Cure

“These [latently infected] cells are present in everybody [with HIV], but they’re very rare—about 1 in a million,” Robert Siciliano, MD, PhD, professor of medicine at Johns Hopkins University School of Medicine and an author of the study, told Contagion®, adding that the medical community has known for roughly 20 years that these cells exist in HIV patients. “What’s new in the last year is understanding why these latently infected cells never go away.”

The scientists discovered that these cells divide without producing HIV, although later they may begin to produce the virus; researchers aren’t sure why this happens. “The finding that they are actually proliferating is disturbing,” Siciliano said, adding that this cell replication is the reason the scientific community has been unable to come up with a complete cure: “This division helps keep these cells from disappearing.” By contrast, he notes, hepatitis C has proven quite curable because a latent form of the disease doesn’t exist. Patients are able to take medications that eradicate the virus; once a person has gone three months without detectable levels of hepatitis C in the blood, he or she is considered cured.

Going forward, Dr. Siciliano and his team plan to focus on HIV’s propensity to replicate. “We’d like to figure out what’s causing the proliferation [of the cells] and if there’s any way to stop it,” he said. If their research yields answers, this will likely represent a real breakthrough in the quest to wipe out HIV for good.

Learn more about reservoirs of latent HIV, here.

#2: UNC Researchers Identify New Target for Potential HIV Cure

A good deal of progress has been made in the fight against HIV. Decades ago, when an individual received an HIV diagnosis, it essentially equated to a death sentence, but now, by receiving antiretroviral therapy (ART), these individuals can live longer lives with fewer side effects. Despite this, once an individual is infected, he or she has HIV for life, and the more that researchers learn about the virus, the closer they may come to finding a cure.

Now, researchers from the Division of Infectious Diseases at the University of North Carolina, School of Medicine have made another interesting discovery. HIV does not only infect T cells—the virus can also “persist” in macrophages. According to the UNC press release, “The discovery of this additional viral reservoir has significant implications for HIV cure research.” Those who are actively working on a potential cure for HIV can utilize these findings to get a leg-up on the virus.

“These results are paradigm changing because they demonstrate that cells other than T cells can serve as a reservoir for HIV,” lead-author Jenna Honeycutt, PhD, post-doctoral research associate in the UNC Division of Infectious Diseases said in the press release. “The fact that HIV-infected macrophages can persist means that any possible therapeutic intervention to eradicate HIV might have to target two very different types of cells.”

Read more about UNC’s discovery, here.

#1: How Close Are We to a Cure for HIV?

It can sometimes be hard to remember that just a few decades ago, contracting HIV was pretty much a death sentence. In HIV-infected individuals, the disease often progressed quickly to full-blown AIDS, and there was nothing doctors could do at that point except offer supportive care.

Fast-forward to the mid-1990s, when protease inhibitors were introduced and the death rate from HIV began a sharp decline. The multidrug “cocktails” of the 1990s and 2000s have since given way to a much simpler, more streamlined, and more effective treatment regimen that allows individuals with HIV to live a near-normal lifespan with fewer side effects than ever before. Although this is great news, the fact remains that HIV is a particularly stubborn virus. Compared with other lethal diseases such as polio or smallpox, the human body mounts an inefficient immune response to HIV, which is why a preventive vaccine remains elusive. Researchers and patients still hope for the day when HIV can be declared completely cured, but is this a realistic vision, and, if so, how close are we to that goal?

The short answer, according to experts, is “We’re getting there.”

Continue reading about how close we are to a cure for HIV, here.