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Researchers unravel part of the puzzle

Art Chimes | St. Louis, Missouri March 17, 2011

HIV is known as the virus that causes AIDS. But in rare cases, a
person infected with HIV does not become sick. Scientists have been
studying these so-called "elite controllers" to better understand how they
avoid AIDS. Researchers have unraveled part of the puzzle.
In the vast majority of people infected with HIV, the virus overwhelms
the immune system. The level of infection can be measured by counting
virus particles in the blood. Mathias Lichterfeld, a researcher at
Massachusetts General Hospital in Boston, says in most patients
it might be 50- or 100,000, or even a million virus particles per
milliliter.

"And in these elite controllers, [who] are really just a very small
proportion of HIV-infected patients, we can't find any of it. So that's
really the point: for some reason, these patients are able to maintain
undetectable HIV replication in the absence of any sort of treatment."
The researchers focused on a protein called p21, which is a normal part
of CD4 immune cells. Those immune cells are targets of HIV, but in elite
controllers, the CD4 cells successfully fight off the HIV invaders.

"And what we figured out in this study is that this protein is just a
lot stronger, a lot more strongly expressed, in patients who are
elite controllers," Lichterfeld explains. "And it's actually pretty
intense, it's like 10- to 20-fold higher, so substantial differences
in comparison to any sort of additional HIV patient and also in
comparison to HIV-negative persons."

Although the exceptional p21 response seems to play a key role in why
elite controllers can be infected with HIV but keep the infection in
check, Lichterfeld says it is probably only part of the process.

"We don't believe that that's the only mechanism. It's probably a
multi-factorial thing and it involves a number of different immunologic
processes."

If those processes can be better understood, Lichterfeld says, it might
point researchers to new strategies beyond the current antiviral drugs
to help HIV-positive people avoid getting sick with AIDS.

Mathias Lichterfeld and his team at the Ragon Institute at Massachusetts
General Hospital describe their research in the Journal of Clinical Investigation.

Category:Aliya Leigh Live - Podcast -- posted at: 2:41pm EST
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