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Eradicate HIV / AIDS infected body

Hopes and false leads 

Eradicate the AIDS virus among 34 million people worldwide are infected is a serious working hypothesis. Professor Alain Lafeuillade, Head of Department of Infectious Diseases at the Hospital General, Associate Professor at the University of Maryland in the laboratory of Professor Robert Gallo in 1984 showed that the causal relationship between HIV and AIDS, member of Scientific Committee Workshop "Towards a Cure" will take place on 20 and 21 July next in Washington under the auspices of the International AIDS Society (IAS) and directed by Professor Francoise Barre-Sinoussi, Nobel Medicine in 2008 for the discovery of HIV in 1983, shares his hopes and doubts about the strategies to be explored.

"The budget for this type of research is still limited, says Professor Lafeuillade, but the patient weight is huge, which is why more than ever, we have no right to make mistakes.

This is the reading of two popular articles published in these days "To Science" (No. 417, July 2012) that its concerns have emerged.

"You cannot suggest to the public that things are so simple and advanced it," said the doctor.

The first strategy mentioned attacks a HIV core ceptor required for infection of cells by viruses: CCR5. The technology used is very heavy, unable to be generalized to other centers who three U.S. laboratories which work there, and not without risks (including long-term cancer). This strategy is driven by the pharmaceutical company that has invented and who cares most of its financing as its practical and scientific aspects.

It is based on the unique, isolated and exceptional "Berlin Patient" in which, we are told, HIV was finally eradicated. We know, from June 8, that HIV persists in low noise in this patient:

Moreover, besides strains using CCR5, there are others using the CXCR4 that is insensitive to this strategy.

The second article praises the strategy of "purge" HIV reservoirs. It is to spit in HIV dormant memory cells, to gradual eliminate them. However, in practice, all trials to date have been unsuccessful (valproic acid) because there is not one but many cellular reservoirs, and each product, which in addition has a weak action is not capable of achieving all of these reservoir cells. "I think, in particular, macrophages," says Professor Lafeuillade. "It was recently demonstrated at the last American Conference on AIDS in March 2012 that those cells in which HIV was reactivated were not eliminated by the immune system,"

In addition, as backstop virals are unable to prevent direct transmission of HIV from an infected cell to a healthy cell, reactivate tank is a real danger.

"Do not forget that in most cases, we are dealing with patients in good general condition under HAART, and we cannot ethically submit to such risks," says the researcher.

"The way that I feel now is the wisest one that seeks to let sleeping living with HIV in the chromosomes of patients without it can never be reactivated" he says. "The mammalian genome contains sequences as well (6% of our genome) ancestral retroviruses have been acquired there are more than 100 million years and remain there, controlled without causing us particular pathologies." It is this way to be preferred, attacking more cell biology than HIV itself if you do not want to disappoint our new patients as we have done in the search for a vaccine against HIV " concluded Professor Lafeuillade. "I participated in several working groups of pharmaceutical manufacturers who develop such avenues of approach revolutionary, and it is to these strategies hope that my healing turns"

Cure AIDS?

Since the first pandemic dated 1981, HIV (human immunodeficiency virus) has stopped spreading. In 2009, 2.5 million people were infected, and 33 million people were infected worldwide. HIV therapy now allowed people with HIV to lead a normal life and life expectancy of these individuals has increased significantly thanks to these treatments.

However, the virus remains latent in "reservoirs" - immune cells scattered in many organs or circulating in the blood. He might wake up at any moment, when another infection stimulates the immune system. This is why treatments must be taken for life.

Can we avoid this limitation? Is there a cure for AIDS? Two complementary strategies are developed. One is to strengthen the resistance of the immune system to prevent virus replication in immune cells and maintain a low level of virus in the patient. The other objective is to eradicate the virus reservoir, in order to remove the body.

These two articles provide an update on the principles of these strategies, progress and hurdles to hope for a cure.

In this issue:

• Push attacks HIV

• Eradicating HIV: What obstacles?

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