'Silent' HIV Infection Lasts A Lifetime

Hopkins Physicians Urge Patients To Keep Taking Anti-HIV Medication

In 1995, researchers at Johns Hopkins discovered HIV (human immunodeficiency virus) evades anti-viral drugs by hiding in the immune system, infecting certain white blood cells, called T cells, and then going to sleep, or turning off. In the May Nature Medicine, the same team reports this silent infection persists for a lifetime.

"This doesn't mean a cure for HIV is impossible, but it is an obstacle," says Robert Siliciano, M.D., Ph.D., senior author on the report. "And it emphasizes that patients need to stay on their medication, possibly for the rest of their lives."

However, not all news from the study was bleak. The study patients, who kept to their strict drug regimens under supervision from physicians at the Johns Hopkins Moore HIV Clinic, all had undetectable levels of HIV in their blood and no signs of AIDS (acquired immune deficiency syndrome).

"The good news is that patients who comply with their therapy are able to keep the virus suppressed for long periods," says Joel Gallant, M.D., who directs the Moore Clinic. "We have assumed that therapy for HIV patients would have to be long-term or even lifelong. This study suggests that is still the case. But the study also suggests that HIV-infected patients can still live long, healthy lives without symptoms, provided they are rigorous about taking their medications." When taken as prescribed, combination therapy (the so-called "drug cocktails") of older anti-HIV drugs like AZT and newer protease inhibitors (PIs) or non-nucleoside reverse transcriptase inhibitors (NNRTIs), reduces the amount of circulating virus to undetectable levels in most patients. The immune system remains relatively healthy and the collection of diseases that signal AIDS is staved off.

But the latent form of HIV can wait out even decades of anti-HIV therapy. First, it integrates its genetic code

Contact: Brian Vastag
Johns Hopkins Medical Institutions

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