Many people living with HIV who adhere to regular anti-retroviral therapy (ART) have undetectable levels of HIV in their blood. However, while these individuals are much less likely to spread the virus or live most of the symptoms and complications, they still have latent HIV in certain body tissues, a phenomenon known as "HIV reservoir". If people with HIV suppression by HAART stop taking the medication, harmful levels of HIV result in an "rebound".
sustained viral remission, also known as a functional curing, refers to the treatment or vaccination would result in prolonged undetectable levels of HIV without regulating therapy.
ART effectively allows the HIV to remain suppressed in blood and without replication tissues to high levels. However, this does not result in effective treatment to cure the disease because HIV can avoid these drugs and natural immune system response, remaining latent in a few cells immune long life. This small amount of HIV that persists in people on ART is called the HIV reservoir.
While individuals HAART playback suppressed HIV are much less likely to spread the virus or suffer from most of the symptoms and complications arising from HIV, for example HIV levels in the blood known as viral load, inure to harmful levels if they interrupt ARV treatment because of the viral reservoir. Many people who are on HAART regimen with undetectable viral loads can live full, healthy lives with and without presenting virus transmission risk to others, but keep this state requires regular treatment and draconian discipline.
A cure to bring sustained viral remission allow a person living with HIV could maintain undetectable viral load without regular treatment or complex treatment regimens, as often it is necessary for people living with HIV for a long time, or even newly infected people which can contract viral strains already resistant, it would have been propagated, in one example, a sexual relationship in which the condom broke or slipped and none of the partners, in the frenzy of the moment, can not realize. A person sustained viral remission would be considered functionally cured HIV infection; he or she would still have to be infected with a very low level of virus, but would be able to live your life with minimal risk of spreading HIV and without the need to take medication daily. Although there are still many existing challenges, both research for treatment and cure are working towards this goal.
anti-HIV therapy optimization
Because antiretroviral therapy is as effective in reducing HIV levels in the blood, some researchers theorized that the introduction of the medication as soon as possible after infection could prevent HIV from the construction of viral reservoirs and this would generate a form of healing formidable and that could help make the ART. Experts initially believed that this had been the case in a child born in Mississippi in 2010. The child was infected with HIV at birth mother but started with aggressive ART ua 30 hours later. She continued to ART first eighteen months of his life before stopping the medication. She did not attend any specialized clinic until five months after the last dose of ARV treatment, but notably, the doctors found that she did not have a detectable viral load. She continued to remain in sustained viral remission for two years when, in 2014, researchers reported that children had detectable levels of HIV. While this was an unfortunate development, this case study sparked a fundamental research on questions and showed that periods of quiescence (Translator's note: temporary stop development or other activity of an organism due to unfavorable environmental conditions) of in the absence of HIV therapy may be possible. A lot of work is being carried out to try to understand where the virus was "hiding" in this girl and what led to the eventual rebound of viral load.
In addition to selecting the correct time to enter the administration of HAART, researchers are also tryingART optimize the therapeutic action of long development that are able to suppress viral load for extended periods of time.
long therapeutic action ART could offer convenience, cost reduction and ease of use for the millions of people around the world who are taking multiple medications daily, or several times a day to keep a low viral load. While these advances in treatment does not replace the need for a functional cure, early and long-acting ART could act as one of the critical components able to achieve complete viral suppression and reduce the size of persistent viral reservoirs to improve the success of remission viral and complete eradication of viral curing strategies.
Medication long anti-HIV action is also being tested for preventive use.
Strengthening the immune system
Most approaches to achieving sustained viral remission involve changes in the immune system to induce long-term control of HIV. Researchers try to manipulate the immune system for therapeutic antibodies and vaccines that target HIV and HIV-infected cells and therapies that alter the immune cell behavior to better deal with the infection.
At the broadly neutralizing antibodies or bNAbs are potent proteins that block infection of a high percentage of global strains of HIV to infect human cells and precipitate the death of cells that have already been infected.
Although they can grow naturally in some people with HIV over time, they usually do in too small quantities to provide a significant benefit, or they are developed too late to control the virus since HIV undergoes mutations over time that put them always one step ahead in the "arms race" that seems to give. The researchers are exploring ways to take various types of bNAbs the ocorrrem course in adequate amounts capable of controlling HIV viral and lead to a remission.
Powerful bNAbs, several of which have already been tested in clinical trials may someday induction of sustained viral remission. Alternatively, a therapeutic vaccine that induces the immune system to produce bNAbs may one day lead to long-term control of the virus.
The researchers are also exploring how immune cells can be manipulated to control HIV in the long run.
chronic viral infections such as HIV infection leads to depletion of T cells in which immune cells called "T cells", which now do not adequately perform their normal functions identify and kill virus-infected cells. Scientists have developed antibodies known as anti-PD1 or anti-PD-L1 were observed in combating depletion of T cellsvitroand clinical trials of cancer by blocking a cell with the ligand-receptor that interacts letando these cells to atrophy and die. Researchers are now checking whether these drugs may be able to help control HIV levels in the blood.Learn more about a recent clinical study of anti-PD-L1 therapy for HIV (external link).
Using another strategy in 2015, the scientists primed (traduror's note: see here) TK cells (specialized immune cells to destroy organic cells "defective", "potentially dangerous" or inadequate to the proper functioning of the "body" A kind of Gestapo) T cells with fragments of proteins of HIV. Scientists have found that these cells suitably stimulated eliminated HIV-infected cells in petri dishes and humans mice genetically modified to have immune systems Note: A Petri dish, and the Petri dish is a cylindrical container, flat glass or plastic lab professionals use for culture of microorganisms. The name was given to this laboratory instrument in honor of the German bacteriologist Julius Richard Petri (1852-1921) who invented it in 1877 when working as assistant Robert Koch(Translator's note: Despite the reservations that wikipédia made to the text, I could not simply ignore the mention of such a man). The study suggests that a therapeutic vaccine may likewise increase the T cell response to HIV can be successful in achieving sustained viral remission.