Fight HIV

“The simple facts are that gay men are decidedly more promiscuous than straight men, and that gay sex has decidedly more health risks than heterosexual sex, even in ‘monogamous,’ committed relationships.

“A data analysis released today by the Centers for Disease Control and Prevention underscores the disproportionate impact of HIV and syphilis among gay and bisexual men in the United States.

“Gay men make up roughly 3% of the population, and yet 64% of all new syphilis cases in 2004 were reported among them. And these statistics have continued to rise.

“Gay and bisexual men account for half of the new HIV infections in the U.S. and have AIDS at a rate more than 50 times greater than other groups.

“The comprehensive review of 100 years of literature by NARTH researchers yielded the following conclusions:

“Despite knowing the AIDS risk, homosexuals repeatedly and pathologically continue to indulge in unsafe sex practices; Homosexuals represent the highest number of STD cases; Many homosexual sex practices are medically dangerous, with or without protection; More than one-third of homosexual men and women are substance abusers; Forty percent of homosexual adolescents report suicidal histories; Homosexual are more likely  than heterosexuals to have mental health concerns, such as eating disorders, personality disorders, paranoia, depression, and anxiety; Homosexual relationships are more violent than heterosexual relationships.”

Michael L. Brown, A Queer Thing Happened to America, p. 487, 488

Fight Against HIV Hits a Roadblock, New Study Shows

Research by Johns Hopkins Scientists Indicates AIDS Virus Might Be Harder to Eliminate Than Previously Thought

Ron Winslow and Betsy McKay, “Fight Against HIV,” The Wall Street Journal, October 25, 2013, p. A2

A study published Thursday found that the amount of potentially active HIV that lurks in infected immune-system cells may be 60-fold greater than previously thought, making the disease harder to eliminate than researchers have hoped. Ron Winslow reports on the News Hub.

New research has dealt a setback to scientists’ quest for a cure for HIV, finding that the virus might be harder to eliminate from the human body than previously thought.

The study, published Thursday, found that the amount of potentially active HIV that lurks in infected immune-system cells could be up to 60 times as large as previously observed. That poses a major hurdle for a promising strategy researchers have hoped might one day eradicate the virus and enable HIV patients to go off therapy.

The study by researchers at Johns Hopkins University in Baltimore damps recent optimism that a cure for HIV, the virus that causes AIDS, could be within reach.

AIDS researchers have known for nearly two decades that HIV goes dormant and hides in so-called latent reservoirs in immune-system cells where it can’t be detected by conventional tests or affected by antiretroviral drugs that attack active virus. But research shows that if therapy is stopped the dormant virus is reactivated, reigniting the infection.

Johns Hopkins scientists say HIV will be harder to eliminate than hoped. Shown, a researcher at the university Johns Hopkins Medicine

As a result, the latent reservoirs are viewed as a major barrier to eradicating the virus and the disease it ultimately causes. The recent apparent cures of an HIV-infected man known as the Berlin patient after a bone-marrow transplant and a baby in Mississippi whose treatment began within 30 hours of birth have helped spark hope that the disease can be conquered.

One emerging strategy is known as “shock and kill,” in which dormant HIV in the reservoirs is deliberately activated and exposed to antiretroviral drugs in hopes of eradicating the latent virus and letting patients stop therapy.

The new report suggests “it’s going to be quite a bit harder than we thought to get rid of all the virus that could rekindle the infection if a patient stops treatment,” said Robert Siliciano, an AIDS researcher at Johns Hopkins and the study’s senior author. The research was published in the journal Cell.

One reason it will be more difficult is the unexpectedly larger size of the reservoir, he said. Another is the researchers’ discovery of a type of HIV that can’t be flushed out of the reservoirs with known “shock” methods but can still replicate and thus potentially rekindle the infection.

“It makes the concept of eradication of the reservoir much more complicated and much more problematic than was originally thought,” said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, who has devoted much of his own research time to the HIV reservoir. “I have always felt that the reservoir is really a very problematic obstacle to the eradication of HIV,” he added. NIAID partly funded the study.

Dr. Siliciano and his colleagues used DNA sequencing and other methods to study HIV cells from reservoirs obtained from eight patients in an effort to learn more about the hidden virus.

Knowing how big the reservoir is and how to measure it is important to determining in studies whether a shock-and-kill strategy is working, he said. Dr. Siliciano, who is also a Howard Hughes Medical Institute investigator, with his colleagues discovered the presence of the reservoirs in research first reported in 1995.

The new results showed that the “gold standard” approach for measuring the reservoirs misses a lot of virus, said Steven Deeks, an HIV researcher at the University of California, San Francisco, who wasn’t involved in the study. “We desperately need a practical way to measure the reservoir,” he said, calling it a “fundamental problem, one I think will be fixed.”

The Johns Hopkins study also found that the method for activating the immune cells harboring the reservoirs didn’t turn on all of the dormant virus. Of the viral cells that weren’t turned on, about 88%, were defective and incapable of replicating or causing the infection to rebound. But 12% “looked to be perfectly intact” and “replicated beautifully” in lab tests, Dr. Siliciano said.

That suggests that “there is some random process” that determines whether the virus is reactivated even when the cells harboring the latent reservoirs are activated, he said.

A major question is whether the HIV that stays hidden after reactivation efforts is likely to rekindle the infection in the body. In principle, Dr. Siliciano said, a single cell with HIV can lead to a rebound of the infection.

Dr. Deeks said the study provides compelling evidence that “eliminating the entire reservoir of potentially infectious virus” will be harder than previously hoped. But it also raises “the interesting possibility that some of the virus may be buried so deep in our own DNA that it will never come out, even after people stop their antiretroviral drugs,” he said.

Write to Ron Winslow at ron.winslow@wsj.com and Betsy McKay atbetsy.mckay@wsj.com

      

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