HIV, the virus that causes AIDS, apparently can hide in bone marrow. It’s the latest evidence to show HIV can lie dormant in many parts of the body.
However, the finding could eventually lead to better treatment of HIV/AIDS.
Dr. Kathleen Collins, associate professor of medicine at the University of Michigan, and her colleagues, conducted the research. She says a different approach is needed to target the dormant virus.
“The drugs that are currently available for the treatment of HIV disease are highly effective at reducing the virus levels in the blood. And they dramatically decrease mortality and reduce it by about 90 percent, which is a really big deal. It’s really important,” she says.
But….
“The drugs do not cure the disease. And so people have to remain on drugs for at least the foreseeable future, possibly for their entire lives. And the reason why the drugs fail is because (the) virus is able to lie dormant in a form that is resistant to the drugs. And when the drugs are stopped the virus is then able to rebound,” says Collins.
The next step is to find out how HIV survives in this dormant state, “so that ultimately we can develop a treatment that will be curative,” she says.
Hiding places
It’s long been known that HIV can hide in many parts of the body, such as the brain. But hiding in bone marrow is different.
“The virus that is in some of these other reservoirs, like (the) brain, are probably in a form that is more short-lived. It’s probably a low-level active infection. The drugs aren’t getting into the brain in high enough levels. What’s different about the bone marrow is that the virus is in a latent form that isn’t toxic to the cells and the cells are long lived themselves,” she says.
HIV can live for many years within those bone marrow cells.
“(It) will require specific reservoir targeting strategies to eradicate,” she says.
Anti-retrovirals are not to blame for the virus going into hiding.
“No, the drugs don’t increase dormancy. The drugs, if anything, decrease dormancy. But they don’t eradicate it (HIV),” she says.
It takes time
While the findings will boost drug development research, it’s not a quick process.
“It can take some time. People have known about reservoirs in resting T-cells (immune cells) and have been working on drug strategies to try to eradicate those reservoirs. And that’s been on-going for about 10 years with limited success,” she says.
She says the T-cell research may provide some clues into targeting the HIV in bone marrow.
“It’s a fairly long term process to develop drugs and to test them in the clinic. Make sure they are safe and then get them on the market for therapy. This is a fairly long term goal and probably won’t change things for people in the near future,” says Collins.
Gone once and for all?
Asked whether it will ever be possible to eradicate HIV from the body, she says, “I’m optimistic that we’ll be able to do that ultimately. I am.”
She says great strides have been made in recent years.
“We’ve gone from having HIV be essentially a death sentence…. And now, we’re in a different world. If people are infected with the virus, there’s a lot of hope. They can lead a near normal life. So that’s a huge difference just in the past 10 or 15 years.
