B Altimore , M ARYLAND - German An infected HIV man levels "undetectable" of the virus in his blood 9 months after you stop taking a powerful combination of drugs to fight against infection. This surprising discovery was announced on September 16 at an AIDS conference here hosted by Robert Gallo, director of the Institute of Human Virology in Baltimore. the AIDS experts are intrigued because viral levels usually bounce when patients stop taking anti-HIV drugs, but they are quick to warn against drawing conclusions from individual cases.
The report is the second anecdotal account of long-term viral suppression in recent weeks. An article published in August 30 Lancet described two patients who, likewise, have not seen their HIV levels rebound after being off drugs for one year, but some researchers question whether these people were really infected.
Franco Lori genetic Research Institute and Human Therapy - which is located in both Pavia, Italy and at Georgetown University in Washington, DC - said the patient, a man in his 20s who lives in Berlin, first sought medical treatment soon after infection. After treatment with indinavir, ddI and hydroxyurea, drugs that have mechanisms of action, human HIV levels quickly dropped to the point that the most sensitive reaction to tests polymerase chain could not detect viruses. This is now a common result in people taking the powerful drug combinations against AIDS
Then, 144 days after the start of treatment, the man developed hepatitis A -. Who would have boosted levels of HIV itself, said Lori-- and was so ill that he could not take his medication for 3 weeks. But the amount of virus in the blood remained undetectable - and it remained so for nine months. Indeed, Lori said he and his colleagues can not find a "weak signal" of the virus in the lymph nodes, where the bulk of HIV resides.
Reactions to Lori's comments was swift and strong. "It's exactly what you can not use it as a proof of concept," said Jacques Leibowitch of Raymond Poincaré Hospital in France. "It serves no purpose, except to the person who took the drugs." Leibowitch and others had even harsher words for the Lancet paper, noting that both patients - who are also using hydroxyurea as part of their treatment - had such low HIV levels to begin they may never have been infected in the first place.
Yet many researchers Leibowitch included, were intrigued by the potential role of hydroxyurea, which is not an approved drug AIDS in the United States. They were also impressed that the patient described Lori had a high initial level of virus in his blood. "There must be something we need to study more," said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases of the United States, which says hydroxyurea could remove the cells of particular immune system that targets HIV. Or maybe, says Lori, drugs led HIV levels so low so soon after infection they served as pharmacological vaccine of sorts. "There are many things we need to work on "says Lori. "It really is an issue."
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