Despite the best available anti-aids drugs, Jefferson scientists detect active HIV in the bloodstream

They call for better detection and improved drugs to eradicate the virus

The best AIDS drugs are still not quite good enough. Scientists at Jefferson Medical College have found evidence for the first time of actively replicating HIV in the bloodstream of patients taking the most powerful anti-AIDS virus drugs available.

Scientists knew that the combination of drugs known as HAART, highly active antiretroviral therapy, did not eradicate the AIDS virus, despite the fact that the virus could not be detected by conventional means in the patient's blood. But they thought that the drugs had at least arrested the virus from replicating. No one had been able to find active virus in the blood of patients still on the drugs.

Until now.

Roger J. Pomerantz, M.D., professor of medicine, biochemistry and molecular pharmacology, and chief of the division of infectious diseases at Jefferson Medical College of Thomas Jefferson University in Philadelphia, and his co-workers examined 22 HIV-infected patients taking HAART. Using ultrasensitive molecular techniques, he and his team found evidence of active virus in the blood plasma of every patient.

The researchers report their results Nov. 3 in JAMA, the Journal of the American Medical Association.

"No one has shown in patients taking these drugs that the virus spills out of the immune cells it normally infects and into the blood, possibly infecting other cells," says Dr. Pomerantz, who also directs Jefferson's Center for Human Virology. "There had not been replication previously detectable in the bloodstream or in genital fluids.

"It teaches us something if we're going to eradicate the virus," he says. "We need to be able to stop replication before we think about eradication."

Dr. Pomerantz calls for better detection methods as well.

"In the era of HAART, a lot of the new technologies in laboratories need to be more genera

Contact: Steve Benowitz
Thomas Jefferson University

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