New Discoveries Expected at the Scientific Workshop on HIV Reservoirs
Fifteen years ago, when ART was discovered, a renewed optimism for a cure gained several scientists who predicted that 3 years of undetectable viremia would be able to get rid of HIV. In 1997, a reservoir of latently-infected cells was demonstrated in patients, which is established very early at acute infection. As these are resting cells which do not usually produce viral particles, they are not destroyed by the immune system and are inaccessible to ART. They also take part to the memory of the immune system, are life-long and would actually need more than 60 years of undetectable viremia to eventually be replaced by uninfected cells...
Despite dramatic decreases in morbidity and mortality with ART, new problems have emerged and life-long ART cannot be considered as the final response to the HIV pandemic. Patients adherence to treatment is variable, with possible selection of resistant strains. Toxicities accumulate with time, in particular of the metabolic type with an increased risk of cardiovascular events, osteopenia, lipodystrophy. Disease evolution is not completely stopped and slowly progressive neurocognitive dysfunction is found in some patients. Persistent chronic inflammation is another proof that the damages inflicted to the immune system and lymphoid organs are not totally reversed. Finally, universal access to ART is a major financial problem and the pandemic remains highly active with more than 7,000 daily new cases of HIV infection worldwide.
To address the issue of a cure, researchers have to set up in vitro and in vivo (animal) models of HIV persistence, define the virological and immunological mechanisms involved in HIV persistence, and discover new drugs acting differently than ART.
Their first objective is to induce a “HIV functional cure”, a situation where the virus would not be replicating and would not cause harm in the absence of ART. This condition naturally exists in a tiny proportion of patients, called ‘elite controllers’. These patients exhibit both low levels of HIV reservoirs and strong anti-HIV immune responses. The ultimate objective of researchers is to obtain a “HIV sterilizing cure”, where the virus is eliminated from the body. Several drugs are already in the pipeline to “flush out” the HIV reservoirs.
The “HIV Persistence, Reservoirs & Eradication Strategies Workshop” will gather all the international community of researchers working on a HIV cure and help define the right scientific path to success.
About the workshop:
International Workshop on HIV Persistence, Reservoirs & Eradication Strategies, December 6-9, 2011, Sin Maarten, website: http://www.informedhorizons.com/persistence2011/
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