HIV and AIDS -- The Facts

HIV is a virus which attacks the immune system, and weakens your ability to fight infections and disease. It's most commonly caught by having sex without a condom.

It can also be passed on by sharing infected needles and other injecting equipment, and from an HIV-positive mother to her child during pregnancy, birth and breastfeeding.

HIV stands for human immunodeficiency virus. The virus attacks the immune system, and weakens your ability to fight infections and disease.

There is no cure for HIV, but there are treatments to enable most people with the virus to live a long and healthy life.

AIDS is the final stage of HIV infection, when your body can no longer fight life-threatening infections. With early diagnosis and effective treatment, most people with HIV will not go on to develop AIDS.

How do you get HIV?

HIV is found in the body fluids of an infected person, which includes semen, vaginal and anal fluids, blood, and breast milk. It is a fragile virus and does not survive outside the body for long. 

HIV cannot be transmitted through sweat or urine.

The most common way of getting HIV in the UK is by anal or vaginal sex without a condom. According to statistics from the Health Protection Agency, 95% of those diagnosed with HIV in the UK in 2011 acquired HIV as a result of sexual contact.

Other ways of getting HIV include:

• using a contaminated needle, syringe or other injecting equipment
• tranmission from mother to baby during pregnancy, birth or breastfeeding
• through oral sex or sharing sex toys (although the risk is significantly lower than for anal and vaginal sex)

Getting tested

Hugger-in-Chief: In embracing an Ebola victim, Barack Obama succeeded where Ronald Reagan failed.

Barack Obama displayed inspiring leadership on Friday. He also promoted public health, fought bigotry, and helped calm raging paranoia. His heroic act? He hugged somebody.

Nina Pham, the first person to be infected with Ebola within the United States, had just been declared disease-free and discharged from the National Institutes of Health. Obama is a rational, science-friendly guy, so he knew she wasn’t any danger to him. It didn’t take courage to hug her.

And yet, another modern president failed a similar test. Facing the greatest public health crisis of his administration, Ronald Reagan was not heroic. He was a dithering coward.

The hateful, homophobic, racist response to the AIDS crisis is one of the most shameful episodes in recent American history. Within a few years after the first AIDS cases were reported in 1981, scientists knew the disease was transmitted primarily by sex, blood transfusions, and shared needles.

That knowledge didn’t stop the prejudice and fear mongering. HIV-positive people were fired from their jobs, forbidden from entering the country, kicked out of the military. Jerry Falwell claimed AIDS was “God’s punishment not just for homosexuals” but for a “society that tolerates homosexuals.” William F. Buckley Jr. wrote in a widely syndicated column that people diagnosed with AIDS should have that fact tattooed on their buttocks. Schools refused to enroll children with HIV. When a judge ordered a Florida school to admit young brothers Ricky, Randy, and Robert Ray, their neighbors burned their house down.

That Time The Reagan White House Press Briefing Erupted With Laughter Over AIDS 13 Times

Hysteria over the Ebola virus is reminiscent of what happened to Ryan White, the child who was stricken with AIDS. The lack of correct information which circulated in the media resulted in a bullet being fired through his family’s living room. The Whites were essentially run out of town.

In Jon Cohen’s 2001 book, Shots in the Dark: The Wayward Search for an AIDS Vaccine, the author detailed the Reagan administration’s early indifference to the growing epidemic. White House acting press secretary Larry Speakes, and some of the reporters at press briefings, found the crisis to be quite the joking matter, Buzzfeed reported last year.

While Republicans are footing the blame of Ebola squarely on President Obama’s shoulders, let’s look how their hero Ronald Reagan handled the growing AIDS epidemic.

Reaganbola via Buzzfeed:

White House Press Briefing — Oct. 15, 1982

Q: Larry, does the President have any reaction to the announcement—the Centers for Disease Control in Atlanta, that AIDS is now an epidemic and have over 600 cases?

MR. SPEAKES: What’s AIDS?

Q: Over a third of them have died. It’s known as “gay plague.” (Laughter.) No, it is. I mean it’s a pretty serious thing that one in every three people that get this have died. And I wondered if the President is aware of it?

MR. SPEAKES: I don’t have it. Do you? (Laughter.)

Q: No, I don’t.

MR. SPEAKES: You didn’t answer my question.

Q: Well, I just wondered, does the President—

MR. SPEAKES: How do you know? (Laughter.)

Human Rights Campaign backs use of daily HIV-prevention pill

The largest U.S. gay-rights organization Saturday endorsed efforts to promote the use of a once-a-day pill to prevent HIV infection and called on insurers to provide more generous coverage of the drug.

HRC headquarters in Washington, D.C.

Some doctors have been reluctant to prescribe the drug, Truvada, on the premise that it might encourage high-risk, unprotected sexual behavior. However, its preventive use has been endorsed by theCenters for Disease Controland Prevention, the World Health Organization, and many HIV/AIDS advocacy groups.

The Human Rights Campaign, which recently has been focusing its gay-rights advocacy on same-sex marriage and anti-discrimination issues, joined those ranks with the release of a policy paper strongly supporting the preventive use of Truvada. It depicted the drug as “a critically important tool” in combatting HIV, the virus that causes AIDS.

“HRC does not take this position lightly,” the policy paper said. “We recognize there is still ongoing debate … and that there are those out there who will disagree with our stance.”

Truvada has been around for a decade, serving as one of the key drugs used in combination with others as the basic treatment for people with HIV. In 2012, the Food and Drug Administration approved it for pre-exposure prophylaxis, or PrEP – in other words, for use to prevent people from getting sexually transmitted HIV in the first place.

“Today, there is an unprecedented chance to end the HIV/AIDS epidemic, in part through PrEP’s aggressive prevention of new HIV infections,” said Chad Griffin, president of the Human Rights Campaign. “There is no reason – medical or otherwise – to discourage individuals from taking control of their sexual health and talking to their doctor about PrEP.”

The CDC says studies have shown that Truvada, when taken diligently, can reduce the risk of getting HIV by 90 percent or more. Research discussed at the International AIDS Conference in July found that use of the drug does not encourage risky sex and is effective even if people skip some doses.

As part of its announcement, the Human Rights Campaign called on insurers, regulators and Truvada’s manufacturer to take steps to reduce costs, raise public awareness, and make the option available to all medically qualified individuals who could benefit from it, regardless of ability to pay.

CONTINUE READING

13 Year-Old Girl Identifies Fungus That Has "Sickened AIDS Patients For Decades"

From the website of Duke University:

Researchers have pinpointed the environmental source of fungal infections that have been sickening HIV/AIDS patients in Southern California for decades. It literally grows on trees. The discovery is based on the science project of a 13-year-old girl, who spent the summer gathering soil and tree samples from areas around Los Angeles hardest hit by infections of the fungus named Cryptococcus gattii (CRIP-to-cock-us GAT-ee-eye). Cryptococcus, which encompasses a number of species including C. gattii, causes life-threatening infections of the lungs and brain and is responsible for one third of all AIDS-related deaths. The student sampled 109 swabs of more than 30 tree species and 58 soil samples, grew and isolated the Cryptococcus fungus, and then sent those specimens to Springer at Duke. Springer DNA-sequenced the samples from California and compared the sequences to those obtained from HIV/AIDS patients with C. gattii infections. She was surprised to find that specimens from three of the tree species were genetically almost indistinguishable from the patient specimens. The researchers also found that the C. gattii isolated from the environment were fertile, reproducing either by sexual or asexual reproduction.

Her name is Elan Filler.

Researchers Eliminate HIV from Infected Human Cell

Researchers at Temple University have successfully managed to eliminate HIV from infected human cell cultures according to a recently released study. Most current HIV treatments target the various means through which HIV integrates itself into healthy host cells in order replicate itself. The team at Temple, however, employed a form of advanced gene therapy in order to render HIV-infected cells completely HIV-free. From the team’s press release:

When deployed, a combination of a DNA-snipping enzyme called a nuclease and a targeting strand of RNA called a guide RNA (gRNA) hunt down the viral genome and excise the HIV-1 DNA. From there, the cell's gene repair machinery takes over, soldering the loose ends of the genome back together – resulting in virus-free cells.

Treatments capable of removing HIV from infected cells have long since been a goal for those within the HIV/AIDS research community. While antiretrovirals are able to suppress the viral loads in HIV positive people, interruptions in treatment give the virus the chance to proliferate, sometimes with dangerous consequences such as cardiomyopathy, kidney disease, and neurocognitive disorders.

"These problems are often exacerbated by the toxic drugs that must be taken to control the virus," explained Dr. Kamel Khalili. "Since HIV-1 is never cleared by the immune system, removal of the virus is required in order to cure the disease."

This development comes just days after a report published at the 20th International AIDS Conference announced that HIV infection rates in general have dropped here in the U.S. The one population observed to have experienced a rise in infection rates were gay and bisexual men.

Controlled tests with the gene therapy method have proven to be successful, but Khalili says that his team still faces a number of significant challenges before the treatment is ready for patient trials. In order to be completely effective the molecular agents responsible for disabling HIV’s replication process would have to be delivered to every cell in an infected individual’s body. Moreover, the strain of HIV that the treatment has proved effective against, HIV-1, is prone to mutation, further complicating the therapy’s effectiveness outside of controlled environments.

"We are working on a number of strategies so we can take the construct into preclinical studies," Khalili said. "We want to eradicate every single copy of HIV-1 from the patient. That will cure AIDS. I think this technology is the way we can do it."

Chad Allen: Marathon Man

Chad Allen has been breaking hearts and barriers since he debuted on the TV series Our House [Actually Chad's first national TV role was on St. Elsewhere] as a teen and later as young adult on Dr. Quinn: Medicine Woman. Long before it was in vogue to do so, he came out publicly and has been a vocal advocate for gay and human rights, and particularly for people living with HIV. This fall, Allen takes this advocacy to the next level, when he will participate in the 2014 Sydney Marathon, raising over $10,000 for AIDS Project Los Angeles helping to save the lives of men and women living with HIV.

How did you get involved with AIDS Project Los Angeles?

Allen with his dog Foxie Brown

I have been involved with AIDS Project Los Angeles as an actor/fundraiser for over 20 years participating in countless events here in LA. But after riding in six AIDS/life-cycles (545 mile bike rides from San Fran to LA to raise money for the LA Gay and Lesbian Centers HIV/AIDS services), I was looking for a new challenge and service opportunity that wouldn't take me away during finals.

I had done my first triathlon and T2 (Team to end AIDS) was doing their first triathlon to benefit APLA. I signed up, trained and that got me into running for the first time in my life... I actually had a spinal disk rupture during tri-training and had surgery before that first tri, and I wasn't able to race. To be honest I didn't know if i'd ever run or bike again. Committing to the idea of raising money for APLA and running the Disney half marathon in winter 2013 gave me a goal to get through the endless recovery and physical therapy. I ran that race for APLA, and it was amazing. For my 40th birthday I wanted to find an awesome challenge to raise some real money with. When the Sydney marathon came up, since I've always wanted to go to Australia and I've never run a marathon before. I knew I was in.

Tell me about the members of your team, how did you guys get together?

The team is a very small group of high fundraisers, all of whom -- I believe -- have run marathons before. I am actually the only first timer. Eeeek. They're a fantastic and supportive group of about 10, mixed gender, age, sexuality and skill levels specifically brought together for their passion and ability to raise good amounts for the cause.

How long is the marathon?

26.2 miles. Olympic marathon distance and the course we are running is the same as the Sydney games a few years back. They say its extraordinarily beautiful!

Have you been to Australia before?

Nope. It's a dream of mine since I was a kid. Everyone who knows me and knows Australia says I'll want to stay. I've heard that my whole life. I can't wait!

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Department of Justice Urges States To Drop HIV Criminalization

The Civil Rights division of the U.S. Department of Justice is strongly urging legislators across the country to strike down laws that currently criminalize HIV-positive people who, often unknowingly, “certain behaviors before disclosing known HIV-positive status.”

HIV criminalization laws sprang up across the country in the early days of the AIDS epidemic when diagnoses and death were swift and sometimes unexpected. In a time when the exact means of transmission were misunderstood and means of treating those infected were scant, the laws were a desperate attempt to curtail the spread of the virus. More robust public health funding was provided to the states in 1990 provided that the states criminalized HIV transmission.

Unfortunately, most of the laws regarding HIV positive individuals and their conduct haven’t managed to keep pace with the development of treatments. Put simply, the laws just don’t work. Last year the United Nations HIV/AIDS prevention task force found that in criminalizing HIV transmission these laws discouraged people from finding out their HIV statuses.

“Generally the best practice would be for states to reform these laws to eliminate HIV-specific criminal penalties except in two distinct circumstances.”

The DoJ’s guide reads:

First, states may wish to retain criminal liability when a person who knows he/she is HIV positive commits a (non-HIV specific) sex crime where there is a risk of transmission (e.g., rape or other sexual assault). The second circumstance is where the individual knows he/she is HIV positive and the evidence clearly demonstrates the individual’s intent was to transmit the virus and that the behavior engaged in had a significant risk of transmission, whether or not transmission actually occurred.

More than 100 AIDS activists killed in Malaysia Airlines plane crash

HIV/AIDS conference in Australia were onboard the doomed flight MH17 when it was shot down over eastern Ukraine, according to reports.

The plane, which was flying from Amsterdam to Kuala Lumpur, was a connecting flight for many people heading to the International AIDS Conference in Melbourne, which was due to start this weekend.

Organisers confirmed to the Sydney Morning Herald that expected conference attendees were among those thought to have died in the crash, with the newspaper reporting that ‘about 100′ attendees were among the 298 onboard the flight.

International AIDS Society spokesperson Michael Kessler said: “A number of colleagues and friends en route to attend the 20th International AIDS Conference taking place in Melbourne, Australia, were on board the Malaysia Airlines MH17 flight that has crashed over Ukraine.”

“At this incredibly sad and sensitive time the IAS stands with our international family and sends condolences to the loved ones of those who have been lost to this tragedy.”

Renowned Dutch HIV researcher Dr Joep Lang, AIDS campaigner Pim de Kuijer, and WHO member Glenn Thomas are among those reported to have been onboard. Tributes to the researchers have been paid across the internet.

Terrence Higgins Trust tweeted: “Stunned by reports that #AIDS2014 delegates inc leading researcher Joep Lange were on #MH17. Terrible news for #HIV community.”

The National AIDS Trust added: “Reports Joep Lange died in Malaysian plane crash today, with other scientists on way to @AIDS_conference. Desperately sad news.”

Stunned by reports that #AIDS2014 delegates inc leading researcher Joep Lange were on #MH17. Terrible news for #HIV community.
— TerrenceHigginsTrust (@THTorguk) July 17, 2014

Reports Joep Lange died in Malaysian plane crash today, with other scientists on way to @AIDS_conference. Desperately sad news.
— National AIDS Trust (@NAT_AIDS_Trust) July 17, 2014

The plane was carrying 173 Dutch nationals, 27 Australians, 44 Malaysians (including 15 crew), 12 Indonesians and nine Britons.

Ukraine has set up a no-fly zone following the incident, and international investigators are currently looking into the cause of the crash.

AIDS researcher Joep Lange confirmed among dead in Malaysia jet shoot-down

Members of the international HIV research community are reeling from the news that many of their own, including world-renowned AIDS researcher Joep Lange, perished when Malaysia Airlines Flight 17 was shot down Thursday over eastern Ukraine.

The victims were on their way to the International AIDS Conference that begins this weekend in Melbourne, Australia, a trip halfway around the world that necessitated a change of planes in Kuala Lumpur.

The identities of the victims have not been officially confirmed by the airlines. But Lange’s office in Amsterdam confirmed in a statement that he died in the crash.

Lange, a Dutch citizen, had been a pioneer in the field since the early days of the AIDS epidemic and had worked tirelessly, his friends and colleagues said, to improve access to life-saving drugs in impoverished corners of the globe.

“His loss casts a pall over the International AIDS Conference just getting underway in Melbourne,” wrote Daniel R. Kuritzkes, a professor of medicine at Harvard Medical School. He called Lange “an extraordinary leader, scientist and humanitarian” who, as a past president of the International AIDS Society and as a leading Dutch academic researcher, “fought ceaselessly for the dignity of all HIV-infected persons throughout the world.”

Shawn Jain, spokesman for the Whitman-Walker Clinic in Washington, said late Thursday by e-mail: “The conference already brings out a lot of emotion in attendees because so many have been lost to HIV/AIDS (and the global epidemic, of course, continues), so to have this happen will only compound the sense of loss that many cope with at this event. To hear that Joep Lange, a former president of the organization that puts on the conference (the International AIDS Society) perished in the crash is especially devastating.”

How The Hobby Lobby Decision Could Undermine The Fight Against HIV/AIDS

The Supreme Court's decision in Burwell v. Hobby Lobby Stores, Inc. could pose a significant threat to the fight for broader access to comprehensive treatment for HIV/AIDS. The ruling, handed down last week, held that closely held, for-profit corporations could be exempt from laws in direct conflict with their religious beliefs.

Hobby Lobby took specific issue with four forms of contraception the Affordable Care Act required it to provide its employees through its healthcare. While the bulk of the Hobby Lobby conversation has centered around religious objections to contraceptives, Media Matters points out that similar arguments could be made against Truvada, a drug just as socially polarizing.

A form of pre-exposure prophylaxis, (PrEP) Truvada has proven itself to be an overwhelmingly effective means of blocking HIV infection when taken properly. With a 99% efficacy rate, an endorsement from the CDC, and increasing deployment in public health initiatives, Truvada has the potential to be a key component in halting new HIV infection rates.

As Carlos Maza points out in Media Matters, however, the conversation around Truvada bears a striking resemblance to the debate about birth control. "[T]he Truvada debate recalls the way birth control was viewed in some quarters in the 1960s -- as an accessory to promiscuity."

President Obama hearts The Normal Heart

President Obama called Ryan Murphy on Monday to tell him he "loved" The Normal Heart and "found it incredibly moving" according to Deadline.

Obama reportedly asked how the movie came together, and Murphy told Deadline: “The whole movie is about Larry trying to get the attention of Washington and 30 years later, to get a call from the President is a full-circle moment.”

Here is a Comprehensive Supercut of News Clips from the First Decade of the AIDS Crisis

HBO's broadcast of The Normal Heart has caused new reflection on the early days of the AIDS crisis, and the fear, ignorance, lack of understanding, and anger that were the hallmarks of that era.

If you care to revisit it, an intrepid newshound Dave Evans has assembled an hour's worth of clips from 1982-1992 covering everything from the first discovery of the disease to Rock Hudson's death, to the ACT UP demonstrations.

Let's hope nothing like it ever happens again.

AHF PRESIDENT MICHAEL WEINSTEIN SPURS OUTRAGE WITH REMAKS ON TRUVADA: 'IT'S A PARTY DRUG'

Slowly but steadily Truvada as PrEP is gaining awareness and acceptance as a valid method for preventing HIV transmission. The drug's reputation is not without its problems, however, including no small number of myths and misinformation that routinely have to be debunked. Adding to the opposition of the drug's uptake is AIDS Healthcare Foundation President Michael Weinstein.

Said Weinstein of the drug:

If something comes along that's better than condoms, I'm all for it, but Truvada is not that. Let's be honest: It's a party drug.

Weinstein received immediate public backlash and condemnation for the remarks.

Mr. L.A. Leather Eric Paul Leue pulled no punches on his Facebook page (some content hidden depending on privacy settings),

I speak out against Weinstein's ignorant form of speech that is attacking our LGBT community and those that are aware[...]He disgraces those that are actively seeking protection, awareness and knowledge by literally calling them drug addicts.

Adult video producer Michael Lucas called for Weinstein's removal as AHF president:

In this man’s prurient imagination, gays are too busy enjoying their bareback orgies to be trusted with taking a once-daily pill. In his view, gay men using PrEP will stir up a frothy new drug-resistant strain of the virus. What evidence exists that this is a valid scientific concern? None. He has not even credited the fact that this form of prevention might and is being used by responsible gay men regardless of the sexual activity they are engaged in. Mr. Weinstein’s anti-PrEP position is an extension of his long-standing anti-promiscuity crusade and more importantly his continuation of harmful shame tactics.

The facts are that Truvada is estimated to be over 99% effective when taken properly. Additionally, the fear that Truvada will encourage riskier behavior is not founded in fact; men are already having condomless sex regardless of the availability of PrEP, and during the iPrEX studies prior to FDA approval there was no increase in risky behavior between the men who thought they were on PrEP versus those who thought they were on the placebo.

GAY MAN REJECTED AS AN ORGAN DONOR

Despite the fact that donated blood and organs can be screened quickly and accurately for STDs and complications, gay men are still treated like plague rats if they haven't been celibate for half a decade. Rohn Neugebauer was a healthy gay man in an 8-year committed relationship who inexplicably died of cardiac arrest at the age of 48. Given that he had recently co-hosted a fundraiser that raised thousands of dollars for a local organ donation organization, the Center for Organ Recovery & Education (CORE), it was no surprise that he was an organ donor himself. Neugebauer's sister went through the interview process with a CORE representative, and when she answered affirmatively to the question of whether Neugebauer had been in a relationship with another man in the past 5 years, he was immediately rejected as a donor.

CORE explicitly invoked an FDA guideline that prohibits tissue donations from sexually active gay men, but the organization's rejection is made perplexing by the fact that the prohibition does not apply to organ donation. CDC guidelines also state that the risk for HIV and disease transmission is so high with donations from gay men that they should be rejected unless the situation is "deemed to be greater than the risk of HIV transmission and disease" and the gay donor is the only option available. The sexual history of heterosexuals, conversely, does not impact their eligibility.

Over 121,000 people are presently on waiting lists for organ donation. CORE's senseless rejection may have just cost some their lives.

HIV AWARENESS, PREVENTION, AND PREJUDICE: WHAT TOPS AND BOTTOMS NEED TO KNOW

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New Technique Offers Hope of Controlling HIV Without Drugs

A new report from the National Institute of Health  suggests that 'gene editing' — removing cells from HIV patients, modifying them and replacing the cells — offers new hope in controlling the virus without drugs.

The NIH reports, via press release:

Scientists today report initial results from humans on the safety and tolerability of a novel strategy to curb HIV disease by removing key cells from HIV-infected individuals, genetically modifying the cells to resist HIV infection and returning them to those people. The basic and pre-clinical research on this strategy, which eventually might help people control the virus without drugs, was funded by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health. The Phase I clinical trial was funded by Sangamo BioSciences and was led by NIAID grantee Carl H. June, M.D., with co-investigators Bruce L. Levine, Ph.D., and Pablo Tebas, M.D., all of the Perelman School of Medicine at the University of Pennsylvania, Philadelphia.  

The trial built on the observation that people who naturally have a genetic modification in a protein called CCR5 are resistant to HIV infection, and when infected with HIV, progress to AIDS more slowly. CCR5 is a cell-surface molecule, or receptor, that most HIV variants must use to enter their primary target: the CD4⁺ T cell. In the trial, CD4⁺ T-cells were collected from each of 12 HIV-infected volunteers whose virus was controlled by anti-HIV therapy. These cells were then treated in the laboratory with molecular tools called zinc-finger nucleases (ZFNs). The ZFNs were designed to snip the DNA within the gene that codes for the CCR5 receptor. This process introduced a genetic mutation rendering CCR5 receptors non-functional. Subsequently, the cells were stimulated to multiply, and each patient received an infusion of 10 billion of their own CD4⁺ T-cells, with roughly a fifth of the CCR5 genes now mutated.

Four weeks later, in a planned interruption of anti-HIV therapy, half the study participants stopped taking their antiretroviral drugs for 8 to 12 weeks. Investigators found that the experimental treatment was generally safe, and that the genetically modified cells appeared to be protected from HIV infection. In one volunteer who naturally had the desired mutation in half of his CCR5 genes, HIV replication was controlled during the entire 12-week treatment interruption. Future research will include evaluating this experimental treatment in more volunteers, as well as maximizing the frequency of CCR5 disruption by ZFNs and increasing the persistence of the genetically modified cells in the body to achieve a therapeutic effect.

Said Dr. Anthony Fauci, director of the NIAID, to the NYT:

“It’s a great strategy. It’s exciting, interesting, elegant science. But a lot of ‘ifs’ need to be addressed before you can say ‘Wow, this could really work.’”

The paper adds: "Dr. Fauci also questioned whether patients would want this relatively complex treatment when many people can keep the infection under control with just one to a few pills a day."

A possible cure for HIV/AIDS?

All of these techniques for attacking HIV, the virus that causes AIDS, are in the early stages of research and development. More research will be needed to see if they prove out before they can begin human trials.

Possible new method to destroy HIV sequestered in human cells

Information from a recent conference has demonstrated some interesting results in the search for a cure for HIV.
One of the main reasons that HIV is so difficult to cure is that the virus can infect some cells (T cells, dendritic cells and some others) and lie dormant there for years. So even with an unmeasurably low viral load in serum, there is still HIV hidden in cells. As time passes, this some of this virus reactivates and is released into the serum again while in other cells it continues to remain dormant. So antiretroviral medications can clear the serum of virus, but not these cells that harbor resting virus.

A research team tried a technique that can be used in cancer chemotherapy to wipe out these nests of virus infected cells. They used an antibody that will attach to those cells that are infected with HIV. Attached to the antibody is a tiny dose of a radioactive substance. The antibody-radioisotope, when applied to a mix of healthy and HIV infected cells, targets the infected cells and binds to them. It holds the isotope close to the cell until the cell dies from exposure to low-level radiation. The cell disintegrates and the cellular debris and the HIV are cleaned up by the body’s immune system. Since the radioisotope is only bound to the infected cells, healthy cells in the vicinity are not harmed.
So far, this has only been done in cells cultured in the lab and in animals. But it may be one method of destroying the reservoir of HIV in infected people, allowing them to finally clear all of the virus and be cured. The next step will be beginning the initial trials in humans.

Alternate method to remove proviral DNA from reservoir cells

When HIV enters human cells it can blend with the host cell’s DNA. It can direct the cell to produce many copies of the HIV virus or it can lie dormant for some period of time. It is this pool of dormant virus that makes the HIV become virtually immortal (see above). Antiretroviral medications can do nothing against the embedded proviral DNA. The method described above may be able to wipe out those cells containing the HIV genetic material using radiation. However, this kills the infected cells some of which are T cells that may already be in short supply. The method described below, can remove the tainted DNA and allow the cell to survive.
Researchers isolated a viral enzyme (Cre) that acts to help get the viral genetic material into the host cell’s DNA and maintain it there. They genetically engineered Cre, making an altered enzyme that is called Tre. Tre, instead of helping the virus incorporate its nucleic acids into the human cell’s genome, as Cre would, does the reverse. It clips out the viral genes. Once the viral genes have been removed, the host cell’s DNA may repair itself and the cell may be able to survive, unlike the radioisotope approach used above.
This approach (using Tre) in humans would probably require gene therapy to allow Tre to be produced in all infected cells. So far, this work has only been done successfully in mice. That means that actually using it as a possible cure is still years in the future. But this may supply another mechanism to attack HIV. This method, and the one described above, may both serve to eradicate the HIV reservoirs that have prevented a cure to date.

Preventing T cell dysfunction

T cells (CD4 cells) are lymphocytes that are necessary for a robust immune response. They can function in different ways to provide protection against non-self molecules. They can act to help B cells (other lymphocytes that produce antibodies) mature, they can activate cytotoxic T cells and macrophages that will then remove foreign substances. They can become activated and then produce cytokines (small proteins like interferon) that can act to neutralize and/or destroy invading viruses.
In patients infected with HIV the number of T cells decreases. HIV infects T cells (and some other cell types). These infected T cells may die as a result of the infection itself or may be killed by CD8 lymphocytes that recognize these T cells as infected. As CD4 cells decrease, the part of the immune response known as cell-mediated immunity begins to fail. As that happens, the patient is left open for infection by opportunistic pathogens. So the infected T cells are underperforming their roles in immunity because of the HIV burden they contain. Additionally, the remaining uninfected T cells sometimes become weakened and are classified as “exhausted.” That is, they are not working as well as they should. Until recently, it wasn’t known why these T cells became exhausted.
New research has shown a possible mechanism that has also suggested a way to prevent this happening to T cells. Scientists have exposed populations of T cells to high concentrations of HIV antigens. What they found was that when the T cells were surrounded by so much antigen, they became overwhelmed. The excess antigen triggered the T cells to produce a chemical named sprouty-2. Sprouty-2 is normally present in small amounts in T cells. In cells exposed to high concentrations of HIV antigens, the T cells produced a lot of sprouty-2. Sprouty-2 acts to help regulate T cell function, among other things. When it is present in high concentrations, it effectively weakens the T cell, “exhausting” it. The cell is much less able to function effectively and, therefore, its ability to activate other cells, produce interferon and other cytokines is impaired.
The researchers think that perhaps by inhibiting sprouty-2 they can prevent the T cells from becoming exhausted and allow them to maintain function. If that is possible, then this may be another mechanism that can help prevent T cell death and help prevent opportunistic infections.

A possible cure for HIV/AIDS?

This is some exciting new information. The proposed treatment with antibody-bound radioisotopes, combined with antiretroviral therapy could possibly be curative, at least in theory. Even if the sprouty-2 research doesn’t lead to a viable treatment to help maintain healthy T cells, it has at least given researchers more insight into another part of the HIV puzzle.

Obama Announces $100 Million Initiative to Build Off Successes and Achieve HIV Cure

President Obama held a World AIDS Day event at the White House yesterday at which he announced a $100 million initiative to develop a cure for HIV, the Washington Blade reports:

“The United States should be at the forefront of new discoveries in how to put HIV into long-term remission without requiting live-long therapies, or better yet, eliminate it completely,” Obama said.

In a fact sheet published after the event, the White House clarified the $100 million would be distributed over the course of three years and would catalyze further research for new therapies to improve outcomes for people with HIV.

Rowena Johnston, amfAR’s vice president and director of research, said in a statement after the event the administration’s efforts to find a cure for HIV would build off previous successes in the past year.

“This year, we saw a series of breakthroughs in HIV cure research that have brought us more clarity than we’ve ever had on the precise steps and tools needed to finally end AIDS,” Johnston said. “We cannot achieve the President’s goal of an AIDS-free generation without continued investment in the research necessary to ultimately help us find a cure for this disease.”

More at The Blade...

Obama also said he plans to sign into law the PEPFAR Stewardship and Oversight Act of 2013, which extends the Bush-era President’s Emergency Plan for AIDS Relief to confront HIV/AIDS overseas. And added that wait lists for federal drugs for HIV/AIDS had been eliminated as part of a $35 million initiative implemented two years ago.

President Obama Issues 'World AIDS Day, 2013' Proclamation

President Obama has issued a proclamation for World AIDS Day 2013, which is today:

BY THE PRESIDENT OF THE UNITED STATES OF AMERICA

A PROCLAMATION

Each year on World AIDS Day, we come together as a global community to fight a devastating pandemic. We remember the friends and loved ones we have lost, stand with the estimated 35 million people living with HIV/AIDS, and renew our commitment to preventing the spread of this virus at home and abroad. If we channel our energy and compassion into science-based results, an AIDS-free generation is within our reach.

My Administration released the first comprehensive National HIV/AIDS Strategy in 2010. Since then, we have made significant progress in strengthening scientific investments, expanding effective HIV/AIDS education and prevention, and connecting stakeholders in both the public and private sectors. At the same time, advances in our scientific understanding have allowed us to better fight this disease. We know now that by focusing on early detection and treatment, we can both prevent long-term complications and reduce transmission rates. To build on this progress, I issued an Executive Order in July establishing the HIV Care Continuum Initiative, which addresses the gaps in care and prevention, especially among communities with the greatest HIV burden. And this November, I signed the HIV Organ Policy Equity Act, lifting the ban on research into the possibility of organ transplants between people with HIV.

My Administration remains committed to reducing the stigma and disparities that fuel this epidemic. Beginning in 2014, the Affordable Care Act will require health insurance plans to cover HIV testing without any additional out-of-pocket costs. It will also prohibit discrimination based on HIV status and eliminate annual benefit caps. Under this law, we have already expanded Medicaid for working class Americans and banned lifetime limits on insurance coverage.

Our work to end HIV extends far beyond our borders. This is a global fight, and America continues to lead. The United States has provided HIV prevention, treatment, and care to millions around the world, helping to dramatically reduce new infections and AIDS-related deaths. This year we celebrate the 10th anniversary of the President's Emergency Plan for AIDS Relief (PEPFAR), a powerful bipartisan effort to turn the tide on this epidemic. Through PEPFAR, we are making strong global progress and are on track to achieve the ambitious HIV treatment and prevention targets I set on World AIDS Day in 2011. Because country ownership and shared responsibility are vital to a2 strong and sustained global response, we launched PEPFAR Country Health Partnerships, an initiative that will empower our partner countries as they progress toward an AIDS-free generation. In the next few days, my Administration will host the Global Fund to Fight AIDS, Tuberculosis and Malaria's Replenishment Conference to enlist new partners, leverage American funding, and increase our collective impact against these diseases. With continued United States leadership, strong partners, and shared responsibility, we can realize this historic opportunity.

We will win this battle, but it is not over yet. In memory of the loved ones we have lost and on behalf of our family members, friends, and fellow citizens of the world battling HIV/AIDS, we resolve to carry on the fight and end stigma and discrimination toward people living with this disease. At this pivotal moment, let us work together to bring this pandemic to an end.

NOW, THEREFORE, I, BARACK OBAMA, President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States do hereby proclaim December 1, 2013, as World AIDS Day. I urge the Governors of the States and the Commonwealth of Puerto Rico, officials of the other territories subject to the jurisdiction of the United States, and the American people to join me in appropriate activities to remember those who have lost their lives to AIDS and to provide support and comfort to those living with this disease.

IN WITNESS WHEREOF, I have hereunto set my hand this twenty-seventh day of November, in the year of our Lord two thousand thirteen, and of the Independence of the United States of America the two hundred and thirty-eighth.

BARACK OBAMA