POZ Community Forums
Main Forums => Living With HIV => Topic started by: jay195 on July 30, 2009, 08:31:12 pm
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Hi there ! I wonder if someone could help me out here. Where does the hiv virus go when we are told we are undetectable ? If they can reduce it , how come it cannot be obliterated altogether ?
Thanks . Jay. kisses.
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hi jay,
there are others here who can answer this better but ill drop a lil info. the virus retreats into reservoirs. i want to say our lymphatic system and other places. there are articles here that cover this as well.
best,
d
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next2u has it right. The primary area of accumulation is the follicular dendritic network in lymphatic tissue. HAART actually is effective at reducing the viral count there, but it's essentially a perfect breeding ground for HIV so you never really wipe it all out.
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Undetectable means just that. It's not detectable with the current standard test in the plasma. The virus can actually be found in the plasma at low levels using the ultra-sensitive test (that is really just the standard test from 10ml of plasma give or take some minor modifications - that make it hard to run and not available as a standard test). The current most sensitive standard test has a sensitivity of 50 copies/ml. That's really good, but below that, the test sees nothing. The virus is still in the plasma and other places, just below the lower cutoff of the test.
If you remove therapy, the virus that remains will reestablish infection. It does live in other places too - but it doesn't go there when on meds - it's always there, the meds just can't get rid of it.
R
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Soon after initial HIV infection (like, within days!) the virus begins to establish itself in immune cells throughout the body, including: macrophages/monocytes, follicular dendritic cells, astrocytes and, potentially, neural progenitor cells as well as 5 different types of Tcells and maybe other cells as well. HIV is able to lay dormant in these cells, known as reservoirs. It uses the CD4 Tcells to make copies of itself.
Current HIV meds (HAART) are only able to get to the virus in the plasma (blood) but cannot reach the virus that is in the reservoirs (listed above). The medications reach the virus that is actively dividing; the virus in the reservoirs is "resting." When undetectable levels of HIV are reached in the blood, it's been shown that whatever small number of viruses are detected , what they call "residual viremia," is coming from the reservoirs (in other words it is not continuous replication occurring in the blood). It's been theorized that continuous successful HAART can eventually eradicate HIV from the body, as it slowly is released from reservoirs into the blood— but it would take up to 60 years!
When HAART medications are stopped the virus that is hiding dormant in the reservoirs is able to begin copying itself again once it enters the blood, which is why for now a person can't stop taking the meds.
Scientists are looking for ways to reach the HIV in the reservoirs (specifically two or three of the Tcell reservoirs, which are believed to be key for eradication) in order to try to eradicate it. It's frustrating because the numbers of resting memory cells infected with HIV capable of reproducing is very, very small (.0002%) but it's enough for HIV to mount a full attack if HAART is stopped.
So the short answer when you ask where does it go is: HIV in the blood is "killed" or disabled by HAART but it continues to exist in the reservoir sites and if HAART meds are stopped, it can come back to life so to speak, and begin to make copies of itself once more.
Here is an interesting link about HIV reservoirs & eradication:
http://www.thebody.com/content/confs/croi2009/art50467.html
EDITED TO ADD:
Since HIV establishes itself in reservoirs so fast, if a person goes on HIV meds very soon after infection (within 48 hours, 72 hours max) it likely can prevent the virus from establishing itself (this is known as "PEP," or post-exposure prophylaxis).
Individuals who start meds within the first year of infection have been shown to have smaller reservoirs than those who start meds later.
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Thanks everyone for your info. That was a very clear explanation Inchlingblue. So this virus is a tough sonofabitch to beat.! I hope and feel that soon there is going to be a breakthrough they certainly seem to be doing their best ( or not ) ? Does anyone have any info on the guy in Germany who was supposedly cured a few months ago.
Thanks ...Jay.........kisses
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Does anyone have any info on the guy in Germany who was supposedly cured a few months ago.
http://forums.poz.com/index.php?topic=24150.0
and posts 5 & 6 in this thread:
http://forums.poz.com/index.php?topic=27421.0
They're both in the Research forum.
:)
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Here's a somwhat related article that shows that infected cells can "dock" with uninfected cells and "dump their load" so to speak. One more clue why some may experience low immune system recovery even when undetectable.
http://www.medicalnewstoday.com/articles/159231.php (http://www.medicalnewstoday.com/articles/159231.php)
Why Retroviruses Such As HIV Love Their Neighbors
Main Category: HIV / AIDS
Article Date: 30 Jul 2009 - 0:00 PDT
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Retroviruses such as HIV that are already within cells are much more easily transmitted when they are next to uninfected cells than if they are floating free in the bloodstream.
"Cell-to-cell transmission is a thousand times more efficient, which is why diseases such as AIDS are so successful and so deadly," said Walther Mothes, associate professor of microbial pathogenesis at the Yale School of Medicine. "And because the retroviruses are already in cells, they are out of reach of the immune system."
Now, Yale University researchers led by Mothes and Jing Jin, a postdoctoral associate in Mothes' lab, have made movies of viral activity within cells that help explain why cell-to-cell transmission is so efficient and provide potential targets for a new generation of AIDS drugs.
Using imaging technology that can track individual particles of virus in real time, the Yale team discovered that infected cells can specifically produce viruses at the point of contact between cells, they report in the July 27 edition of the open access journal PLoS Biology. Ten times more of these particles are found at these cellular poles than elsewhere at the surface of cells, the researchers report. The ability of infected cells to specifically produce viruses only at cell-cell interfaces explains how viruses spread so efficiently, they note.
The researchers also identified a possible weakness in the transmission chain. The team found that viruses express a sticky protein that docks with uninfected cells and then attracts viral assembly to these sites. If this adhesion molecule lacked a "cytoplasmic tail," then the viral particles did not assemble at the jumping off point between cells.
Mothes expects many more such targets will be identified as scientists work out the mechanics of cell-to-cell transmission. "We are just opening the door to this whole process," Mothes said. "It is a black box, and many, many cellular factors have to be involved in making this happen. Our hope is that somewhere down the road we will have a completely new anti-viral strategy based on targeting cell-to-cell transmission."
Nathan M. Sherer was another Yale-affiliated author of the paper.
The work was funded by the National Cancer Institute and amfAR, The Foundation for AIDS Research.
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Retroviruses such as HIV that are already within cells are much more easily transmitted when they are next to uninfected cells than if they are floating free in the bloodstream.
The fact that HIV is already within cells is behind one of the latest strategies to emerge for eradication which involves using targeted chemotherapy in order to kill the Tcell reservoir cells that are harboring HIV. Rather than try to get at the virus, or try to get it to "wake up" so HAART can kill it, just kill the whole cell. If the cell dies, the virus dies.
LINK:
A New Weapon in the War Against HIV-AIDS: Combined Antiviral and Targeted Chemotherapy
http://www.thebody.com/content/art52738.html
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Inchlingblue always has the answers.
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Inchlingblue always has the answers.
LOL, not really, but.....Inchlingblue is not working full-time right now so he spends like 5 hours a day reading up about all things HIV. What fun! ;)
A bit obsessive, I know, but it's my way of feeling better about the whole thing.
The more I learn about it = the less scared I am.
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But your postings are very interesting.
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...and helpful.
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OK, now I'm blushing. ;)
Gracias.