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To: JOHN W. who wrote (2759)11/13/1997 5:47:00 PM
From: Henry Niman  Respond to of 6136
 
John, As I said a month or two ago, Dr. Ho is overly optimistic:
BUSINESS WEEK ONLINE
November 13, 1997

Edited by Douglas Harbrecht

THE AIDS DRUG COCKTAIL IS STILL
NO CURE

In a highly publicized development last year, a few AIDS researchers
began to suggest that a cure could be in sight for the scourge of AIDS.
Dr. David Ho of the Aaron Diamond AIDS Research Center and
others based this hope on encouraging results from a potent
combination of three drugs. The drugs were able to reduce the amount
of virus in the blood to undetectable levels in many patients. Ho and
colleagues suggested that using these drugs to keep HIV in check in
the blood could enable the body to clear itself of all traces of the virus
within three years. However, two new studies published in the Nov. 14
issue of the journal Science show that hopes of a cure are vastly
premature. The separate studies reveal that despite up to 30 months of
treatment with the potent drug cocktail, the virus still lurks hidden in the
immune-system cells of patients. That helps explain why patients who
skip doses or stop taking their drugs see blood levels of the virus soar
again. And it means that victims will probably have to keep taking the
expensive drug combination (assuming that the drugs continue to work
and their often-serious side effects can be kept in check) for the rest of
their lives. "The bad news is that we can't yet get rid of the virus
entirely," says Dr. Robert F. Siliciano of Johns Hopkins, the leader of
one of the studies. That's why many scientific groups are now stepping
up efforts to find other ways of attacking the virus, such as
manipulating biochemical pathways -- involving molecules called
chemokines -- that are crucial to viral entry into cells.

By John Carey in Washington



To: JOHN W. who wrote (2759)11/13/1997 5:52:00 PM
From: Henry Niman  Respond to of 6136
 
Note that Dr. Ho is a co-author of the paper:
Identification of a Reservoir for HIV-1 in Patients on
Highly Active Antiretroviral Therapy

Diana Finzi, Monika Hermankova, Theodore Pierson, Lucy M. Carruth,
Christopher Buck, Richard E. Chaisson, Thomas C. Quinn, Karen Chadwick,
Joseph Margolick, Ronald Brookmeyer, Joel Gallant, Martin Markowitz, David D. Ho,
Douglas D. Richman, Robert F. Siliciano *

The hypothesis that quiescent CD4+ T lymphocytes carrying proviral DNA provide a reservoir for
human immunodeficiency virus-type 1 (HIV-1) in patients on highly active antiretroviral therapy
(HAART) was examined. In a study of 22 patients successfully treated with HAART for up to
30 months, replication-competent virus was routinely recovered from resting CD4+ T lymphocytes.
The frequency of resting CD4+ T cells harboring latent HIV-1 was low, 0.2 to 16.4 per 106 cells,
and, in cross-sectional analysis, did not decrease with increasing time on therapy. The recovered
viruses generally did not show mutations associated with resistance to the relevant antiretroviral
drugs. This reservoir of nonevolving latent virus in resting CD4+ T cells should be considered in
deciding whether to terminate treatment in patients who respond to HAART.

D. Finzi, M. Hermankova, T. Pierson, L. M. Carruth, C. Buck, R. E. Chaisson, T. C. Quinn,
J. Gallant, R. F. Siliciano, Department of Medicine, Johns Hopkins University School of Medicine,
Baltimore, MD 21205, USA.
K. Chadwick and J. Margolick, Department of Molecular Microbiology and Immunology, Johns
Hopkins University School of Hygiene and Public Health, Baltimore, MD 21205, USA.
R. Brookmeyer, Department of Biostatistics, Johns Hopkins University School of Hygiene and
Public Health, Baltimore, MD 21205, USA.
M. Markowitz and D. D. Ho, Aaron Diamond AIDS Research Center, 455 First Avenue, New
York, NY 10016, USA.
D. D. Richman, Departments of Medicine and Pathology, University of California San Diego, La
Jolla CA 92093, USA.
* To whom correspondence should be addressed.