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People gather next to a sign reading AIDS 2014 in Melbourne on July 18 after news that downed Malaysia Airlines flight MH17 was carrying many participants headed to the 20th International AIDS Conference planned this weekend in the Australian city. Several reports being presented to coincide with an international AIDS conference this week may at first raise hopes that it could be possible to cure HIV infection. Scientists have invented two dozen different drugs that can slow down the virus, and people who take a cocktail of the drugs can seem uninfected.
She seemed cured, but disappointed doctors reported earlier this month that the child, now just shy of 4, is indeed infected. Doctors had hoped that if patients got bone marrow transplants while taking HIV drugs, the virus would not be able to take hold in the freshly transplanted bone marrow cells - which are the source of new blood cells.
A study released at the AIDS conference and published in the journal Nature may help explain why.
In the monkeys treated as quickly as three days after infection, there was no detectable immune response to HIV and no evidence of the virus in their blood. One new piece of hope comes from a team at Temple University School of Medicine, that developed a way to cut HIV out of the cells it infects.
But their method excised the virus from the cells, allowing the cells to heal, they reported in the Proceedings of the National Academy of Sciences. They combined an enzyme called a nuclease, which cuts apart DNA, and a programmed strand of genetic material called a guide RNA. The approach is similar to gene therapy, a technique that has only a spotty history of success after more than 15 years of human trials.
Researchers of the University of Texas Medical School in Houston have recently announced that they might have found a way to fight off the human immunodeficiency virus for good by altering the part of its genetic code than never mutates. When interacting with abzymes, the HIV virus is basically rendered harmless and could theoretically be controlled in order to reduce the effects of the disease and the risk of infecting other people. Although it's a great example of the wonders of modern science, the recent miracle cure of a toddler with HIV in Mississippi will have likely have a neutral impact on the sales and share prices of the drug companies responsible. Three drugs were reportedly used to treat the infant: AZT (Zidovudine) and Lamivudine and Nevirapine. So drug companies like Viiv Healthcare -- a joint venture between GlaxoSmithKline (GSK) and Pfizer (PFE) -- and Germany's Boehringer Ingelheim, which makes Nevirapine, will be hard-pressed to capitalize financially on the good news. Further, even if the cure could be repeated in other HIV-infected babies – this still translates into a very narrow market for drug companies.
There's also the fact that HIV drug manufacturers make money from patients being dependent on these drugs for the rest of their lives. Somaiya also points out that HIV drug companies have had a tough time capitalizing on other breakthroughs recently. Last July, the FDA approved a once a day pill, Truvada, that could prevent a healthy person from contracting HIV.
So when it comes to terminal illnesses like HIV, drug companies have a greater chance of gaining market share by developing ways to improve care rather than focusing on cures. Thanks to antiretrovirals, an AIDS diagnosis hasn't been a death sentence for nearly two decades.
Patients must adhere to a demandingly regular drug regimen that carries plenty of side effects.
The problem with HAART is that it doesn't address HIV's so-called proviral reservoirs – dormant forms of the virus that lurk within T-cells and other cell types. The lab has created a collection of "bryologs" designed after a naturally occurring, but difficult to obtain, molecule. The first attempts to reactivate latent HIV were inspired by observations of Samoan healers. Prostratin binds to and activates protein kinase C, an enzyme that forms part of the signaling pathway that reactivates latent viruses. The National Cancer Institute initiated a Phase II clinical trial for the compound in 2009 for the treatment of non-Hodgkin lymphoma. Patient enrollment was suspended until more accessible compounds came out of the Wender Group's lab.

Wender, who published the first practical synthesis of prostratin and its analogs in 2008, had set out to make a simpler, more effective synthetic analog of bryostatin. The seven resulting compounds, called bryologs, share two fundamental features with the original bryostatin: the recognition domain, which directly contacts protein kinase C, and the spacer domain, which allows the bryolog-protein kinase C complex to be inserted into the cell membrane.
The researchers tested the new compounds' ability to reactivate viral reservoirs in J-Lat cell lines, which contain latent HIV and begin to fluoresce when they express the virus. In the J-Lat line, bryologs induced virus in as many or more cells than bryostatin at a variety of concentrations, and ranged from 25 to 1,000 times more potent than prostratin.
Bryolog testing remains in the early stages – the researchers are currently conducting in vivo studies in animal models. Primary authors are Stanford chemistry graduate student Brian Loy and doctoral students Brian DeChristopher and Adam Schrier, in collaboration with Professor Jerry Zack, co-director of the UCLA AIDS Center, and Dr. News that a baby in the US was effectively cured of HIV following aggressive therapy consisting of three different drugs shortly after birth generated great excitement on Monday.
Details of the case were revealed on Sunday at the Conference on Retroviruses and Opportunistic Infections in Atlanta. The case is exceptional because the child was started on treatment within 30 hours of birth. But paediatric HIV specialist Harry Moultrie said he was not convinced that doctors would be able to replicate the treatment in other children. Moultrie said that while the case was both interesting and important, more information was needed before doctors could draw conclusions about how to treat babies who are infected with HIV at birth.
Ashraf Coovadia, a specialist in paediatric HIV at Rahima Moosa Mother and Child Hospital, agreed that it was too early to consider replicating the treatment in other babies suspected of having HIV. Coovadia urged parents not to assume that this case meant that an HIV-positive child could stop their treatment. The case raised questions about how soon children born to HIV-positive mothers could be started on treatment and what sort of treatment would work best to prevent HIV from progressing in babies. HIV-positive women who receive antiretroviral therapy during pregnancy can reduce the chances of passing the virus on to their babies to less than 5%. Government is set to announce new treatment guidelines for the prevention of mother to child transmission of the HI-virus in April.
Gauteng defies the public protectorThe Nkandla ConCourt should have helped a small black-owned business owed R9.6m by the provincial government but it hasn’t. Zuma is reined in by top brassTop ANC members are putting their foot down and demanding that all key appointments be made through the ANC deployment committee. But two other major developments make it clear that it’s pretty much back to the drawing board for researchers trying to find a way to thwart the virus. Vincent’s Hospital and the Kirby Institute in Sydney, Australia, say two men who got bone marrow transplants to treat their cancer appear to be free of the virus.
That’s what makes it so hard to fight—it infects the very cells that the body sends out to fight invaders like viruses.
No one knows where, but almost invariably, if people stop taking the drugs, the virus turns back up after a while.
The transplant replaced Brown's own infected cells with healthy, AIDS-resistant cells, and he remains free of the virus more than five years later. Ari Bitnun of Toronto's Hospital for Sick Children, who is treating five Canadian children infected at birth, is also not giving up hope. It’s in monkeys, which cannot be infected with human AIDS but which can get a similar virus called SIV. But DNA from the virus could be found in cells of the gut and lymph nodes in all of the monkeys. They only performed the work in lab dishes – a long way from doing something in a living animal, let alone a person. It’s very hard to deliver such technology to every cell in the body, for one thing, and it’s not clear the guide RNA could hunt down HIV in its hiding place.
So far the laboratory tests indicate that the technique is effective, although until it is tested on humans it cannot be implemented as a possible cure.

But a key factor in their success was that the baby began treatment almost immediately after birth. The price of HIV drugs is steep -- they can cost between $15,000 and $20,000 a year per patient. And while the therapy may be difficult to undergo in the United States, it is nearly impossible to scale to the AIDS crisis in the developing world. Even after all of the body's active HIV has been eliminated, a missed dose of antiretroviral drugs can allow the hibernating virus to emerge and ravage its host all over again. The new compounds have been shown to activate latent HIV reservoirs with equal or greater potency than the original substance. When ethnobotanists examined the bark of Samoa's mamala tree, traditionally used by healers to treat hepatitis, they found a compound known as prostratin. The discovery sparked interest in the enzyme as a potential therapeutic target, especially as it was discovered that prostratin isn't the only biomolecule to bind to the kinase. The molecule, named bryostatin 1, was deemed to hold promise as a treatment, not only for HIV but for cancer and Alzheimer's disease as well.
But the substance had a number of side effects and proved prohibitively difficult to produce. But practical bryostatin substitutes may be the first step toward true HIV-eradication therapy.
But paediatric HIV specialists warned on Monday that it was too early to say whether the treatment would have the same effect in other children. As a result, the child was healthy, did not need treatment and was believed to be unlikely to be infectious to others. In another, Canadian researchers say four babies treated right after birth show no sign of the virus, either.
Like all viruses, HIV hijacks the cell and forces it to pump out copy after copy of virus until it dies. It happened earlier this year in the so-called Mississippi baby, who was infected at birth and treated with a strong cocktail of HIV drugs right away instead of the usual lighter dose given to newborns of infected mothers. Four of the babies treated at birth are still free of detectable virus, and one is eight years old. As soon as treatment stopped, the virus reappeared in all the monkeys, including those treated at three days.
But even if it works, it could take at least five years before it may be able to treat people infected with HIV. The virus needs at least one constant region, and that is the essence of calling it the Achilles heel," states Dr.
Sudhir said, is to start human trials, although the much needed funding for this crucial step has so far failed to appear. This is what nightmares are made of - that after 30 years of work, you find it doesn't work.
As a result, the combination won't necessarily have the same miraculous impact on HIV-infected adults. Dan Barouch of Beth Israel Deaconess Medical Center and colleagues infected 20 monkeys with SIV and gave them HIV drug cocktails at between three and 14 days afterwards – simulating what happened with the babies. That's because pregnant mothers with the disease are often treated with a cocktail of antiretroviral drugs well before delivery. But Truvada's huge price (approximately $13,000 a year) and distressing potential side effects (neck swelling, kidney problems, trouble speaking) led few healthy people to jump on the bandwagon.
A fifth child was taken off the drugs and the virus came back, just like in the Mississippi baby. He also says that people could take advantage of this weakness with the help of a monoclonal antibody known as abzyme, which is naturally produced in the human body.

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