The most effective drugs to suppress HIV - protease inhibitors - can enhance the immune systems damaged at the resurgence of HIV. The surprising discovery, reported in tomorrow's issue of The Lancet , suggests that all AIDS patients should continue taking protease inhibitors, even if the drugs do not eliminate the virus directly .
The addition of protease inhibitor drug "cocktails" of AIDS patients take to suppress HIV infections has made a big difference in the effectiveness of therapies. If treatment begins soon after infection, the drugs can suppress HIV until it is undetectable. The cocktail also increases the number of CD4 + T cells, the immune cells that attack HIV and other infectious invaders. But in about half of patients with AIDS, HIV continues to be detected or reappear months later. Doctors tend to see this as a sign that the therapy no longer works and often switch to alternative treatments.
Last year, researchers at the Vaudois University Hospital of Lausanne, Switzerland, noted that some AIDS patients who weren 't responding to the cocktail, as judged by their persistent levels of HIV have nevertheless appeared to be free of secondary infections. To see if the drugs were helping the bounce of the immune system, despite the presence of the virus, the researchers continued to give protease inhibitors to 101 outpatients a day. After 48 weeks, the number of CD4 cells in 91 of the patients had on average almost doubled - even among those who still had detectable levels of HIV in their blood. "These people have received and are stable," said a member of the team Amalio Telenti. Patients who discontinued treatment with protease, on the other hand, considerably developed their immune system back, said Telenti. Their number of cells CD4 fell by almost two thirds.
It is difficult to understand why protease inhibitors help the immune system to recover even in the face of continued viral replication. medications can make a sort of new particles HIV unable to kill the CD4 cells, said David Margolis, a virologist at the Institute of human virology in Baltimore. Or the treatment may have some unknown advantage on the immune system itself.
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