HIV may rebound if therapy stops
Information from the National Institute of Allergy and Infectious Diseases
In two HIV-infected patients treated with potent combinations of anti-HIV drugs, and in whom even highly sensitive tests could detect no viable HIV, the virus quickly rebounded to substantial levels when therapy was stopped.
The new findings add to recent reports that suggest eradicating HIV from the body with currently available anti-HIV therapies is unlikely because the virus can hide in sanctuaries which drugs cannot access and can exist in a latent form on which drugs have no effect.
Scientists frequently refer to these sanctuaries, which are established very early in the course of HIV infection, as viral "reservoirs." These reservoirs, in which the virus continues to replicate at low levels even during aggressive treatment, are probable sources of the resurgent HIV seen when therapy is discontinued.
"The persistence of HIV reservoirs poses a significant impediment to the long-term control of HIV infection and must be addressed by comprehensive approaches to the therapy of HIV-infected individuals," says NIAID Director Dr. Anthony Fauci. "Our research and that of other groups underscores the importance of developing more potent anti-HIV therapies, treatment strategies that specifically target the hiding places of HIV, as well as therapies that preserve and enhance HIV-specific immunity."
In the current study, authors two patients were treated with highly active antiretroviral therapy for 33 and 30 months, respectively. Both patients also had received intermittent intravenous infusions of IL-2 for 42 and 50 months, respectively. Before discontinuing therapy, both had levels of HIV in their plasma below 50 copies per milliliter of blood. But the question was whether levels of HIV would remain low following discontinuation of therapy.
Unfortunately, the answer was no. When these patients discontinued therapy, HIV virus was detected in the plasma of both individuals within three weeks.
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