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HIV MAY RAISE RISK OF HEART ATTACK :-

MONDAY, March 4 (HealthDay News) --

People living with HIV may face a greater chance of suffering a heart attack, a new study indicates.Researchers looked at data on more than 82,000 U.S. veterans, and found that there were 871 heart attacks in this group over a median follow-up of 5.9 years. The investigators also found that HIV-positive people had a "consistently and significantly higher" risk of heart attack across three decades of their lives.Among the veterans, heart attack events per 1,000 people per year were: at ages 40 to 49, 2.0 for those with HIV and 1.5 for those who did not have HIV; at ages 50 to 59, 3.9 for those with HIV versus 2.2 for those without HIV; at ages 60 to 69, 5.0 for those with HIV versus 3.3 for those without HIV.After accounting for other risk factors, the researchers calculated that people with HIV have an overall 48 percent increased risk of heart attack.The study was published online March 4 in the journal JAMA Internal Medicine.

The findings may not be applicable to women because the patients included in the study were overwhelmingly male, study author Dr. Matthew Freiberg, from the University of Pittsburgh School of Medicine, and colleagues noted in a journal news release.The success of antiretroviral therapy means that HIV-infected people are living longer, and are now at greater risk for heart disease, the authors added.While the study found an association between HIV and increased risk of heart attack in the veterans, it did not prove a cause-and-effect relationship.However, the findings show "a clear and consistent excess risk" of heart attack in HIV-positive people across a range of age groups, Patrick Mallon, from the University College Dublin in Ireland, wrote in an accompanying commentary. He added that further research is needed to learn more about the causes of this increased risk and how to reduce it.

Researchers Describe 1st 'Functional Cure' of HIV in Baby

SUNDAY, March 3 (HealthDay News) --

A baby born two-and-a-half years ago in Mississippi with HIV is the first case of a so-called "functional cure" of the infection, researchers announced Sunday.Standard tests can no longer detect any traces of the AIDS-causing virus even though the child has discontinued HIV medication."We believe this is the first well-documented case of a [functional] cure," said study lead author Dr. Deborah Persaud, associate professor of pediatrics in the division of infectious diseases at Johns Hopkins Children's Center in Baltimore. The finding was presented Sunday at the Conference on Retroviruses and Opportunistic Infections, in Atlanta.The child was not part of a study but, instead, the beneficiary of an unexpected and partly unplanned sequence of events that -- once confirmed and replicated in a formal study -- might help more children who are born with HIV or who at risk of contracting HIV from their mother eradicate the virus from their body.Normally, mothers infected with HIV take antiretroviral drugs that can almost eliminate the odds of the virus being transferred to the baby.If a mother doesn't know her HIV status or hasn't been treated for other reasons, the baby is given "prophylactic" drugs at birth while awaiting the results of tests to determine his or her HIV status. This can take four to six weeks to complete. If the tests are positive, the baby starts HIV drug treatment.The mother of the baby born in Mississippi didn't know she was HIV-positive until the time of delivery.But in this case, both the initial and confirmatory tests on the baby were able to be completed within one day, allowing the baby to be started on HIV drug treatment within the first 30 hours of life."Most of our kids don't get picked up that early," Persaud explained.As expected, the baby's "viral load" -- detectable levels of HIV -- decreased progressively until it was no longer detectable at 29 days of age.Theoretically, this child (doctors aren't disclosing the gender) would have taken the medications for the rest of his or her life, said the researchers, who included doctors from the University of Massachusetts Medical School and the University of Mississippi Medical Center.Instead, the child stayed on the regimen for only 18 months before dropping out of the medical system and discontinuing the drugs.Ten months after stopping treatment, however, the child was again seen by doctors who were surprised to find no HIV virus or HIV antibodies with standard tests.Ultrasensitive tests did detect infinitesimal traces of viral DNA and RNA in the blood. But the virus was not replicating -- a highly unusual occurrence given that drugs were no longer being administered, the researchers said.No one is absolutely sure why this child achieved a "functional" cure -- meaning the virus is in remission even without medications. But investigators believe that giving antiviral treatment so early in life meant the virus had no time to create viral "reservoirs" where dormant HIV cells can linger for years before becoming active again."For us this is a very exciting finding," said Persaud. "By treating a baby very early [we may be able to] prevent viral reservoirs or cells that stay around for a lifetime of an infected person."But Dr. Michael Horberg, chair of the HIV Medicine Association and director of HIV/AIDS at Kaiser Permanente, stressed that this was a "functional cure and not a cure in the most classic sense of the word.""If we take adults off HIV medications, they almost certainly within a short time period would have levels of virus back to where they were before they were taking medication," he said.Only one instance of a "sterilizing cure" -- when there are absolutely no traces of HIV in the body -- has been documented. This occurred in the so-called "Berlin patient," who received a bone marrow transplant for leukemia. The transplanted cells came from a donor who had a rare genetic mutation that increases immunity against the most common form of HIV. The Berlin patient has remained HIV-free after discontinuing drug therapy.And Persaud said she is not advocating that the Mississippi case become the standard of care. "This is a single case and we don't really know what are all of the factors [involved]," she said.But the case does "pave the way now for us to immediately start clinical studies to see if we can replicate these findings in more infants," Persaud said. Those trials are ready to move forward.At the last follow-up, the child born in Mississippi was "doing well and was healthy," she added.Horberg said the findings in the baby were "encouraging" but "time will tell" if such a strategy can keep the virus under control for long periods of time without medication.He emphasized that there are ways to prevent a baby from becoming infected in the first place."This again shows the importance of testing pregnant mothers and getting them into care and on [drug] treatment such that we wouldn't even need to worry about it at this point," he said. "What's encouraging, though, if it does come to this point, we might have some good treatment options."he research presented Sunday was funded by the U.S. National Institutes of Health and the American Foundation for AIDS Research 

Certain Skin Cancers More Common in HIV-Positive People

Non-melanoma skin cancers are more common among people who are HIV-positive, according to new research.The study found that basal cell and squamous cell carcinomas, two of the most common forms of cancer in the United States, occur more than twice as often among those with HIV (the virus that causes AIDS).The greater risk for cancer among people with HIV is likely due to immune system deficiency, the researchers said, and those with the virus should take extra precautions to protect and monitor their skin."The clinical implications for these findings include increased vigilance in skin-cancer screening for HIV-positive individuals, especially for squamous cell carcinomas and particularly for those who are not on antiretroviral therapy or who were diagnosed late and have more advanced HIV/AIDS," senior study author Dr. Maryam Asgari, a dermatologist and investigator at Kaiser Permanente's division of research, said in a Kaiser news release."HIV-positive individuals should also be advised to reduce behaviors that may further increase non-melanoma skin cancer incidence, such as excessive sun exposure," Asgari added.The study, using data from 1996 to 2008, involved more than 6,500 HIV-positive patients and nearly 37,000 other patients who tested HIV-negative.HIV-positive patients were more than twice as likely to develop basal cell carcinomas, the study revealed. They also were nearly three times more likely to be diagnosed with squamous cell carcinomas.Patients with squamous cell carcinomas often had lower CD4 counts, which is a measure of immunodeficiency. The researches noted that previous treatment with antiviral therapy was not linked to either form of skin cancer.Lead study author Michael Silverberg, also of Kaiser's division of research, said, "These findings represent unique data on non-melanoma skin cancers in HIV patients. Most cancer registries, on which previous studies relied, do not record these types of cancers.""Given the increasing longevity for HIV-positive individuals, the burden of many age-related, non-AIDS-defining cancers, including [non-melanoma skin cancers], will only continue to increase," Silverberg said. "Based on our studies, non-melanoma skin cancers are by far the most common cancer this population experiences."The findings have implications for changes in treatment, Asgari said."Given the observed association of immunodeficiency and squamous cell carcinomas, earlier initiation of antiretroviral therapy to maintain higher CD4 counts may also help reduce the burden of this cancer," she said.More than 3.5 million new cases of non-melanoma skin cancers are diagnosed in the United States each year. Although most of these cases can be easily cured, many become locally invasive and destructive, according to the release.

The study, funded by research grants from Pfizer, Kaiser Permanente Northern California Community Benefit and the U.S. National Institutes of Health, was recently published online in the Journal of the National Cancer Institute.

An effective vaccine against the AIDS virus may have moved one step closer to reality, researchers said Thursday.Federal researchers have identified a pair of naturally occurring antibodies that are able to kill more than 90% of all strains of the AIDS virus, a finding they say could lead to the development of new treatments for HIV infections and to the production of the first successful vaccine against the virus.HIV, the virus that causes AIDS, is notoriously mutable, changing the composition of proteins on its surface with ease to escape pressure from the immune system. This enables it to continue

infecting cells even after the appearance of antibodies targeting it — and to avoid the relatively ineffective vaccines developed so far.Hundreds of variants of the virus are now in circulation around the world, and the identification of so-called broadly neutralizing antibodies that can block the bulk of them has been the holy grail of HIV researchers.To date, however, the best antibodies — immune system proteins that fight infections — that researchers have found block only 30% to 40% of all HIV strains. The identification of antibodies that can block more than 90% of strains could lead to what some researchers are dubbing a renaissance in AIDS prevention and treatment.The key to the new antibodies is that they bind to a site on the virus surface that rarely mutates."I am more optimistic about an AIDS vaccine at this point in time than I have been probably in the last 10 years," Dr. Gary Nabel of the National Institute of Allergy and Infectious Diseases told Reuters. He led the research reported Thursday in the online edition of the journal Science.Nabel and his colleagues isolated the antibodies from the blood of a 60-year-old African American gay man. Using newly developed imaging and analytical techniques, they found that the two antibodies, called VRC01 and VRC02, bind to a spike on the surface of the virus. This spike interacts with a receptor called the CD4 binding site on the surface of human cells, and when an antibody binds to it, the virus cannot enter a cell.Because the virus must use CD4 to enter cells, it cannot tolerate mutations in the spike. The composition of the spike is thus pretty much constant in all variants of HIV in circulation."The antibodies attach to a virtually unchanging part of the virus, and this explains why they can neutralize such an extraordinary range of HIV strains," Dr. John R. Mascola of the infectious diseases institute, a coauthor, said in a statement.the antibodies in hand, the team was able to determine precisely how the HIV spike and the antibodies interact. They were then able to produce a synthetic version of the spike that could elicit the production of similar blocking antibodies in animal cells.They are now testing the synthetic spike as a possible vaccine in animals and hope to expand to human testing in the relatively near future. The antibodies can also be reproduced by biotechnology and used as a treatment for someone who is already infected.Researchers, who are already testing the antibodies in infected animals, hope that at the very least the antibodies will provide synergistic effects when used in conjunction with antiviral drugs.

French research gives scientists hope of 'functional cure' for HIV:

Small group of patients were able to stop taking Aids drugs without any resurgence of the virus in their bodies, study find

The study is one of several that have boosted hopes not of a total cure for HIV, but of what is being called a functional cure. Photograph: Carolyn Kaster/AP

A small group of patients with HIV in France have been able to stop taking Aids drugs without any resurgence of the virus in their bodies, giving scientists new hope that a "functional cure" for HIV may be possible.The Visconti cohort, as the 14 French patients are being called, were all given antiretroviral drugs to control the virus soon after becoming infected with HIV, which is not very common. They remained on medication for at least three years, but then stopped.Usually, the levels of virus in the body will rise without drug suppression and cause the patient to become ill and eventually develop Aids. But the Visconti cohort has remained well, with extremely low levels of virus in their system, for a median of seven years."We believe that this is a really promising group of patients," said Asier Saez Ciron from the Institut Pasteur in France, one of the scientists involved in the research which was presented at the International Aids Conference in Washington.The existence of people who do not become ill even though they are infected with HIV – the so-called "HIV controllers" – is already known. The excitement felt by scientists over the Visconti cohort is because it appears that medical intervention has brought about similar results."This is a promise that the functional cure could be achieved," said Saez Ciron.The work is further evidence that people should be given drugs as soon as possible."These results suggest that the antiretroviral treatment should be started very early after infection," said Charline Bacchus, lead researcher on the study at the French National Agency for Research on Aids and Viral Hepatitis (ANRS).The study is one of three pieces of work presented at the conference this week that have boosted hopes not of a total cure for HIV, but of what is being called a functional cure, because the virus remains in the body at very low levels but does not cause disease and the patient is able to stop taking medication.A campaign by scientists to find a cure for Aids has been gathering momentum over the last two years, culminating in a blueprint published just ahead of the conference in Washington. Francoise Barré Sinoussi, Nobel prize laureate for identifying the human immunodeficiency virus (HIV) in the 1980s, is leading the drive, which she says must go hand in hand with efforts to find a vaccine.Timothy Ray Brown, the so-called Berlin Patient, has been the proof of concept. Brown, who is an American living in the city, had HIV and leukaemia.When he underwent a stem cell transplant for his cancer, his doctor found a donor who had genetic resistance to HIV. Brown's cancer and his HIV were cured. However, he had serious complications from the treatment, which would be unrealistic and unaffordable for most people.The conference also heard, however, of two more stem cell transplants that appear to have resulted in functional cures. The two men with HIV had lymphoma, a cancer of the lymphatic system.They underwent stem cell transplantation for the cancer, but this time not involving donors with genetic resistance to HIV. They received mild chemotherapy which allowed them to stay on their antiretroviral medication throughout.Although HIV was detectable in heir cells immediately after the transplant, over time the uninfected donated cells replaced the infected cells. Both patients appear to be HIV-free, one of them two years and the other three and a half years after their operationA third study by David Margolis and colleagues at the University of Carolina, published in Nature, appears to show that it is possible to reach the low levels of virus that "hide" in cells and have never been susceptible to treatment, using a dose of a drug that inhibits an enzyme involved in "silencing" HIV.

RECENT DICOVERIES . :-

• Scientists discovered a previously unknown step in the HIV replication process. They found that sulfonation, a type of chemical modification, takes place in the early phase of infection to ensure the viral genes can be efficiently expressed after it has successfully integrated into the host genome. Their findings suggest that drugs that block the sulfonation pathway may render the host cells resistant to HIV infection.

• A collaborative study has identified 295 host cell proteins the HIV virus uses to successfully establish infection. By revealing the virus' roadmap for the first time, the recent finding may lead to the development of a new class of HIV therapeutics aimed at disrupting the human-HIV interactions that lead to viral infection.

• Salk researchers recently discovered that HIV targets active genes when it inserts itself into a host cell's genome. These genes are currently being replicated, making it more likely that HIV will itself be replicated and the infection spread. The study demonstrates that HIV has evolved a highly efficient mechanism for reproducing itself.

• Researchers have also found that a newly discovered antiviral regulatory system, RNA interference, could be adapted to inhibit HIV replication and disease in a model organism. They are working to develop a potential drug candidate to inhibit the integrase enzyme. Inhibiting this enzyme might prevent HIV from being able to integrate itself into a host cell's genome.