XLPharmacy December 2008 Health News Archive

There is real hope that what’s happening in a Houston lab might lead to a cure for HIV. HIV AIDS Research story and video

Researcher holds test tubes with separated HIV infected blood. “We have found an innovative way to kill the virus by finding this small region of HIV that is unchangeable,” Dr. Sudhir Paul of the University of Texas Medical School at Houston said.

Dr. Paul and Dr. Miguel Escobar aren’t talking about just suppressing HIV – they’re talking about destroying it permanently by arming the immune system with a new weapon lab tests have shown to be effective.

Ford Stuart has been HIV positive for 15 years. He’s on a powerful drug cocktail that keeps the disease in check.

Dr. Paul thinks he’s cracked a code.

“We’ve discovered the weak spot of HIV,” he said. Paul and his team have zeroed in on a section of a key protein in HIV’s structure that does not mutate. “The virus needs at least one constant region, and by taking advantage of something called an abzyme. It’s naturally produced by people, like lupus patients. When they applied that abzyme to the HIV virus, it permanently disarmed it.

“What we already have in our hand are the abzymes that we could be infusing into the human subjects with HIV infection, essentially to move the virus,” Paul said.

Basically, their idea could be used to control the disease for people who already have it and prevent infection for those at risk.

The theory has held up in lab and animal testing. The next step is human trials. “If we can get the viral loads down to a manageable level, that will preclude the need for these conventional drugs,” Escobar said.

Still, even if everything goes well, it’s at least five years before the research could help people with HIV.

The doctors know there are millions of people waiting.

“There are so many people struggling with the disease because it affects not only your body, but also your psyche, how you perceive yourself,” he said.

If nothing else, the research is promising for the tens of millions waiting for a cure.

Today we at XLPharmacy beseech anyone who is able to consider a contribution to this research. Research is very expensive and there are millions waiting. When HIV and AIDS was first diagnosed HIV patients would live between a few months to a few years after diagnosis.

With modern day therapy, that maintains a safe level of the HIV viral load, an HIV infected individual can live a normal adult lifespan but will have to take antiretroviral drugs every day of their lives. If this breakthrough that Houston has found can find the enormous amount of funding it is going to need, we are certain that the future of millions will be so much brighter. -XLPharmacy

XLPharmacy would like to clarify the many misconceptions about HIV and AIDS. Many of the myths about HIV/AIDS include how you get it. In general, the spread of HIV/AIDS involves an exchange of bodily fluids between an infected and an uninfected person. How does this happen?

Accidental needle sticks or splashes of blood can result in HIV/AIDS infection. This is why you see doctors, dentists, nurses, emergency medical personnel, hospital staff and athletic trainers taking precautions against spreading the virus. Precautions include wearing surgical masks and gloves.

But, for the most part, the spread of HIV/AIDS results from the kind of high-risk behaviors described in the section What are the risk factors for HIV/AIDS? HIV/AIDS may be transmitted by:

Having unprotected sex (sex without a latex condom) with a person who is HIV-positive. The virus can be in an infected person's blood, semen, or vaginal fluids and can enter your body through tiny cuts or sores in your skin, or in the lining of your vagina, penis, rectum or mouth.
Sharing needles and syringes to inject drugs, or sharing drug equipment used in preparing those drugs with someone who has HIV.

Receiving HIV-infected blood or blood products before 1985. Since 1985, all blood used for transfusions in the United States has been tested for HIV and is generally considered safe.
Carrying, giving birth to or breast-feeding a child while HIV positive.

The only way to know for sure whether you are infected is to be tested. This involves a blood test.

You cannot rely on symptoms to know whether you are infected with HIV. About half the people who are infected have flu-like symptoms within two to four weeks of having been exposed to HIV. However, just as many people infected by HIV do not have any symptoms at all for many years.

Over time, as the immune system weakens, maybe over months or years, symptoms begin to develop. The following may be warning signs of HIV infection:

HIV tests do not actually test for the virus, but test for antibodies to the virus. Antibodies are made by the body's white blood cells to fight infection. If these antibodies are present in your blood, you are HIV-positive and need treatment.

If you think you have been exposed to HIV, it is important to be tested as soon as possible, whether you have symptoms or not. The sooner you can get treatment, the less your immune system will be damaged. Unfortunately, the antibodies to the virus don't appear right away. It can take eight to twelve weeks for the antibodies to show up in a test.

What are some of the “opportunistic infections” and side effects linked to HIV/AIDS?

AIDS-Related Non-Hodgkin's Lymphoma (NHL)
Anemia
Bacterial Pneumonia
Oral Candidiasis (Thrush)
Vaginal Candidiasis
Cervical Cancer
Cytomegalovirus (CMV)
Hepatitis A
Hepatitis B
Hepatitis C
Herpes virus
Kaposi's Sarcoma (KS)
Mycobacterium Avium Complex (MAC)
Menstrual Problems
Pneumocystis Carinii Pneumonia (PCP)
Toxoplasmosis (Toxo)
Tuberculosis (TB)

HIV/AIDS: Questions to Ask the Doctor
(Health A to Z): This site lists questions to ask doctors if you have just tested positive or been diagnosed with HIV/AIDS.

Treatment & care: Questions to ask your doctor
(British HIV Association and International HIV/AIDS Alliance): Treatments: Questions to ask your doctor covers basic information about AIDS medications. What to expect, what the drug looks like, how to take it, side effects, and relief of side effects are discussed. Answers tell you how and where to get more information.

Office Visit Checklist
(Mdchoice.com): Office Visit Checklist is a checklist for your regular appointments. Use it to help you remember what to ask your doctor about on your next visit.

Featured Stories II - HIV Evolution

How does HIV evolve?
HIV evolution in the body does not occur at a constant rate. Rather, the virus's rate of change suddenly slows when the level of crucial immune cells known as CD4+ T-cells falls in a patient.

There are several possible reasons for why HIV slows its evolution later in the disease process. One is that there are simply fewer immune cells left for the virus to infect. Another possibility is that since the immune system is no longer as effective targeting the virus, the virus no longer feels the "selective pressure" of the immune system, and the virus slows its evolution in response.

Huh?
Picture a criminal on the lam. When the police are out in force, the criminal must change his disguise more and more to survive, but when fewer police are present, the criminal can change his disguise less often. In the case of HIV, the virus actually eliminates the "police officers" – CD4+ T-cells patrolling the body. As time goes on and fewer immune cells are present to flag HIV, the virus no longer has the need to evolve as rapidly as it did when the cells were out in force.

But I Have a Strong Immune System
In a person with a strong immune system, the virus is constantly on the run – it has to change to survive, but even in a person who has lived with HIV for a decade or more, in most cases, at some point, the immune system weakens. The virus notices and evolves accordingly. It's a very dynamic process.

What's the Research?
While the research shows that the virus is creating fewer new versions of itself late in the disease process, the researchers say the clinical implications of the research are unclear. Since the virus's ability to evolve is at the heart of the drug-resistance capability that makes HIV so deadly, the work could help scientists who are trying to figure out new ways to stop the virus.

It's possible that this work would have some implications for their understanding of drug resistance late in the disease process. When HIV is evolving more slowly in a patient, that patient is less likely to develop resistance to treatment so quickly.

How Does HIV Progress?
Scientists have debated the pace of change of HIV in the body. Some studies have suggested that the virus evolves slowly in people who live many years with HIV before developing AIDS, while other studies showed that the virus evolves quickly in those patients.

To address the issue, a team of researchers developed a mathematical and computational model of how HIV evolves in the body. They tested the model by analyzing the blood from 15 HIV patients whose blood was sampled every few months for anywhere from three to 12 years. The data came from the HIV Sequence Database at Los Alamos National Laboratory, which holds more than 250,000 genetic sequences of HIV from patients around the globe.

What Did the Test Show?
The team found that the when the immune system is relatively healthy, the HIV virus evolves at a constant and rapid rate, but when a patient's CD4+ cells decrease, HIV's rate of evolution slows. The shift occurs long before a patient is considered to have AIDS, which is indicated when the CD4+ level drops to 200 cells per microliter of blood. The finding was true of 13 of 15 of the patients.

The team focused its attention on 600 nucleotides of the RNA that make up HIV's env gene, which codes for the protein's outer envelope that the virus uses to bind onto the cells of the host. In the team's study, on average, slightly less than one mutation per month occurred per patient in this swath of the HIV genome during the time when CD4+ levels were relatively high and the rate of change was constant.

And That Means?
That's a very rapid rate of change for one small portion of a virus, especially one so prolific: Every day, the HIV virus population in an infected person – up to 10 billion viral particles – copies itself and recreates 95 percent of its particles. With all that reproducing, and without a high regard for accuracy, one change leads to another, and the results are astounding: Most patients have literally many thousands of different types of HIV virus in their bodies.

"Every single person on Earth who is infected with HIV has his or her own unique HIV population," said Leitner (who was involved in the research).

As the virus mutates, giving birth to viral offspring called quasispecies, it presents an ever-changing face to the immune system, which is continually adapting itself to keep up with the onslaught. The immune system does a remarkable job fending off the assault, killing most of the viral particles every day. Even so, some of the virus is able to elude the body's defenses and ultimately devastates the immune system in most patients.

Participate in a Blogging Call to Action on December 1st

Link People to HIV Testing Centers via Text Messaging

Attend the World AIDS Day Event in Second Life

Tell people about the CDC’s New HIV Incidence Data