HIV research may improve treatment

The results of University research showed that current drugs poorly penetrate tissues where the virus replicates most.

HIV research may improve treatment

Kristoffer Tigue

HIV/AIDS treatment has majorly improved over the last decade — with advances from simpler drug regiments to longer life expectancy in patients and fewer side effects.

But University of Minnesota researchers say the research they published last month, which shows where current HIV drugs are failing to work, may be a step toward even more effective treatment of the disease and a better patient experience.

Viruses, like HIV, need to use living organisms to reproduce, essentially hijacking the host’s cells to replicate its DNA and spread to more hosts. The research showed current drugs and administration methods don’t properly treat the virus in the lymphatic tissues, where most viral replication takes place.

Lead author and medical professor Dr. Timothy Schacker said that because current drugs don’t target the lymph nodes, the virus re-emerges as soon as a patient discontinues treatment — one of the reasons they can’t cure the disease.

“You can get them down to the level where the HIV is undetectable,” Schacker said. “But as soon as you take them off the drugs, the HIV virus comes right back.”

HIV is a lymphatic infection, Schacker said, because the virus prefers to attack the white blood cells that live in lymph nodes. He said more than 35 FDA-licensed drugs are on the market, all of them aiming to reduce virus’s ability to replicate. But none of the drugs are properly targeting the lymphatic tissues, he said.

“This is another example of infectious diseases that we are attempting to treat and measure through the blood when the blood is clearly not the most effective channel,” Schacker said.

Microbiology department head and co-author Ashley Haase worked with Schacker on the research and said current treatments are working well. But now that they know where these drugs are failing to go, they can start working on finding new drug combinations that better penetrate lymphatic tissues, he said.

Executive Director of the Minnesota AIDS Project Bill Tiedemann said Minnesota typically has between 280 to 370 new HIV infections annually. The Minneapolis-based nonprofit provides resources for people who are or may be infected with HIV/AIDS, such as testing, financial guidance and treatment assistance.

They currently serve about 400 people, but about 7,500 are living with HIV in Minnesota, and Tiedemann said he believes it is still an epidemic.

Haase said University researchers began the study in 2008 when they noted patients receiving treatment for HIV were showing immune system complications, even though their blood tests showed low levels of the virus. They noticed younger patients developing conditions associated with old age, like cancer and cardiovascular disease — a sign that the virus was still active.

“It isn’t that these are weird or unusual cancers,” Schacker said. “It’s that they’re now getting lung cancer, colon cancer, and this is in a 30- or 40-year-old.”

Especially compared to a decade ago, patients on treatment today have improved lives, Schacker said. But a patient on treatment now still has a 20 percent reduction in life expectancy, he said.

This means a person expected to live to 80 may die from HIV complications in their 60s, he said.

Their research studied the six most common HIV treatment drugs, and Schacker said the next step is to survey the remaining available drugs to see which may be most effective in penetrating the lymphatic tissue.

“We think we can do better than we’re doing now,” Schacker said. “And if we do better with suppression, we think that’s going to have a very positive clinical benefit.”