Achieving sustained remission of HIV without life-long antiretroviral therapy (ART) is a top HIV research priority, according to a new commentary in JAMA by experts at the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.
ART involves taking a combination (usually three) of drugs daily, often combined into a single pill. ART has transformed the lives of people with HIV, enabling those with access to the medications to live a near-normal lifespan. Despite this success, the side effects, pill fatigue, stigma and expense of taking daily ART for life have motivated researchers to find an alternative, write NIAID Director Anthony S. Fauci, M.D., and colleagues.
Consequently, scientists are seeking ways to put HIV into full and sustained remission so daily ART is unnecessary. The authors say feasible approaches must involve minimal risk and manageable side effects for people with HIV and must be inexpensive and scalable to millions of individuals.
A major obstacle to sustained ART-free HIV remission is the persistence of viral reservoirs. These reservoirs consist of HIV-infected cells containing HIV genetic material that can generate new virus particles. The cells have entered a resting state that they maintain until they are activated to produce HIV.
The authors explain that two paths are being pursued toward sustained ART-free HIV remission: total eradication of the HIV reservoir, classically referred to as a "cure," and sustained virologic remission, which would control HIV replication but not eradicate the virus. The authors outline specific strategies under investigation to achieve these goals.
Several approaches to eradicating the HIV reservoir have been attempted, but none except stem cell transplantation from a donor with a specific genetic mutation has succeeded--and only in two cases. The risks, expense and complexity of stem cell transplants make them impractical for eradicating the HIV reservoir in people who do not require such a transplant for a separate underlying health condition, the authors write.
Many cutting-edge strategies to achieve sustained virologic remission are being studied. The authors describe how some of these strategies have the potential to replace daily ART with an intermittent or continual non-ART intervention, while others seek to induce permanent immune-mediated control of HIV without further intervention. Clinical trials of numerous different approaches are underway.
TW Chun et al. Durable control of HIV infection in the absence of antiretroviral therapy: opportunities and obstacles. JAMA DOI: 10.1001/jama.2019.5397 (2019)
NIAID Director Anthony S. Fauci, M.D., is available for comment.
To schedule interviews, please contact Laura S. Leifman, (301) 402-1663, email@example.com.
NIAID conducts and supports research--at NIH, throughout the United States, and worldwide--to study the causes of infectious and immune-mediated diseases, and to develop better means of preventing, diagnosing and treating these illnesses. News releases, fact sheets and other NIAID-related materials are available on the NIAID website.
About the National Institutes of Health (NIH): NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.
NIH...Turning Discovery Into Health®
Laura S. Leifman | EurekAlert!
Rising water temperatures could endanger the mating of many fish species
03.07.2020 | Alfred-Wegener-Institut, Helmholtz-Zentrum für Polar- und Meeresforschung
Moss protein corrects genetic defects of other plants
03.07.2020 | Rheinische Friedrich-Wilhelms-Universität Bonn
Solar cells based on perovskite compounds could soon make electricity generation from sunlight even more efficient and cheaper. The laboratory efficiency of these perovskite solar cells already exceeds that of the well-known silicon solar cells. An international team led by Stefan Weber from the Max Planck Institute for Polymer Research (MPI-P) in Mainz has found microscopic structures in perovskite crystals that can guide the charge transport in the solar cell. Clever alignment of these "electron highways" could make perovskite solar cells even more powerful.
Solar cells convert sunlight into electricity. During this process, the electrons of the material inside the cell absorb the energy of the light....
Empa researchers have succeeded in applying aerogels to microelectronics: Aerogels based on cellulose nanofibers can effectively shield electromagnetic radiation over a wide frequency range – and they are unrivalled in terms of weight.
Electric motors and electronic devices generate electromagnetic fields that sometimes have to be shielded in order not to affect neighboring electronic...
A promising operating mode for the plasma of a future power plant has been developed at the ASDEX Upgrade fusion device at Max Planck Institute for Plasma...
Live event – July 1, 2020 - 11:00 to 11:45 (CET)
"Automation in Aerospace Industry @ Fraunhofer IFAM"
The Fraunhofer Institute for Manufacturing Technology and Advanced Materials IFAM l Stade is presenting its forward-looking R&D portfolio for the first time at...
With an X-ray experiment at the European Synchrotron ESRF in Grenoble (France), Empa researchers were able to demonstrate how well their real-time acoustic monitoring of laser weld seams works. With almost 90 percent reliability, they detected the formation of unwanted pores that impair the quality of weld seams. Thanks to a special evaluation method based on artificial intelligence (AI), the detection process is completed in just 70 milliseconds.
Laser welding is a process suitable for joining metals and thermoplastics. It has become particularly well established in highly automated production, for...
02.07.2020 | Event News
19.05.2020 | Event News
07.04.2020 | Event News
03.07.2020 | Life Sciences
03.07.2020 | Studies and Analyses
03.07.2020 | Power and Electrical Engineering