Health/Fitness » HIV/AIDS

AIDS Day 2011: Advancements in HIV

by Andrew Clark
EDGE Media Network Contributor
Friday Dec 2, 2011

From inception, HIV/AIDS seemed like an unbeatable juggernaut, ravaging through the LGBT community and spreading into all corners of the world. Poignant stories of the 1980s through late 1990s tell of unavoidable heartbreak whenever the virus touched a person's life.

And while 30 years is a horrifically long amount of time for such a virus to continue to spread, it is within the last 10 years that increasingly exceptional discoveries and advances have been found. It has finally become possible to do more than simply prevent contraction or to ease symptoms. The virus can be treated with an array of antiretrovirals that can, combined with lifestyle choices, keep those that have been diagnosed completely healthy for years.

But these measures, however miraculous they have been to those with HIV/AIDS, are not a cure. The latent reservoirs of HIV hidden in the body are ready to spread the moment antiretrovirals stop being taken, and also can slowly intensify the spreading of the virus. It is these latent strains that have caused particular problems in regard to treatment.

Furthermore, continuous barriers mostly consist of the limited knowledge that the medical world still has on certain aspects of HIV and its manifestation. Early stages of the virus' activity still remain unclear, and many of the interactions between HIV and its host have not been identified. This is, of course, problematic when creating a treatment. It is difficult to stop a virus from spreading when it is still uncertain how it operates.

The need for a cure is imminent regardless of how effective the treatments have come to be. There have been numerous levels of research on finding either a sterilizing cure or a functional cure, the difference between the two being that a sterilizing cure is one that would wipe all traces of HIV from the body. A functional cure would create more of a long-term and possibly permanent remission with safe and exceptionally low viral levels.

In the last couple of years, there have been strides made toward both types of cures. The most famous of these cases is of course that of the Berlin Patient. (See EDGE's article on The Berlin Patient here) While it is discouraging that his particular procedure would be near impossible to replicate to the masses due to time and financial restraints as well as the severe health risks that went with it, the success of the work done on Timothy Brown's CCR5 gene has inspired new waves through the scientific community and pushed the field of HIV/AIDS research flying into what could be the right direction.

One area of research that has seen an increase in popularity in 2011 is that of gene therapy and how the case of Timothy Brown relates to it. Recent work has involved simply knocking out the CCR5 receptor gene that HIV uses to infect and have that work as an intervention between the white blood cells and the infection. It is not yet clear whether this could be used on those already infected with much result, but it is an easier and more readily available option rather than stem cells.

Recent developments lead scientists to believe that these "elite controllers" have a healthy and efficient way of staving off the replication and infection that HIV is known for producing.

Another interesting and near integral factor to include in any forthcoming research are the people being called "elite controllers." They are a small group of people who have been living with HIV for more than 10 years and having never taken antiretroviral treatments do not develop AIDS. While there is still danger for them, and they admittedly are not cured of HIV, it is promising that there are those who do not have the same level of danger related to their viral loads as the majority of people infected with the virus.

Recent developments lead scientists to believe that these controllers have a healthy and efficient way of staving off the replication and infection that HIV is known for producing. While this is essentially one of the functional cures, it is another direction for the field to examine.

And finally, one of the most important and promising areas of research has come from focusing on the latent HIV reservoirs. As it was mentioned before, latent HIV is a dormant strain that often can be found in immune system cells, and does not replicate. It is because they are dormant that they have become particularly difficult to treat. One of the antiretrovirals' main purposes is to block the replication of HIV in the body. While this works quite well on the active HIV cells, the latent cells are not replicating, and are therefore unaffected.

Due to the latent HIV's dormant nature, one of the beginning strategies for targeting it would be to activate the dormant cells. Together with the HIV-repellant antiretrovirals, the idea would be to quickly ensure that all of the HIV becomes active, and then the rest of the body is "padded" with the antiretrovirals to prevent them from being infected. While this could be a case of oversimplifying the process, it is the simplicity that is so appealing as it would not be as costly or risky as many of the other possible treatments.

It is, of course, extremely frustrating and emotionally distressing that better treatment has not been found yet. But let's take a moment to remember not what we haven't accomplished, but how far we have come in just the last five years. Easier, more cost-effective treatments have been made available to the public; widespread education and testing resources have continued to grow; and the urgency of the virus has led to global cooperation and collaboration on the search to find a cure.

Every year the world continues to progress further toward a longer-lasting and more effective treatments to HIV/AIDS. The hope is that once these treatments are found, that a cure will not be too far behind it.

Treatments including stem cell, antiretrovirals, and gene therapy are all being tested and are progressing in tandem to create a better, safer world. It may not be a world that is free of HIV just yet, but in 2011 it became more clear than ever that we are one step closer to our goals.

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