The secret of long term non-progressors (HIV+ but never developing AIDS) may have been discovered

Nature Immunology (DOI:10.1038/ni845) via New Scientist ^ | 10-06-02 | Philip Cohen

[Neuromancer]

Another theory has emerged to explain why some HIV-infected patients stay healthy despite years of infection. Researchers in the US and the Netherlands have traced the ability to immune cells that replicate rapidly.

Immunologists have long been eager to crack the secret of long term non-progressors - HIV-infected patients who never develop the health problems of AIDS. For 16 years researchers have thought the answer might lie in a product of immune cells called CD8 T cells.

Sometimes called killer T cells for their ability to destroy cells infected with virus, researchers had found the CD8s also spray out a small, unidentified protein that can halt HIV replication without killing cells. Just last week, researchers in New York announced they might have identified this elusive CD8 antiviral factor (CAF), though that claim remains controversial.

But CAF may not be the whole story, says Mark Connors at the National Institutes of Health near Washington DC. He is working with a subset of nonprogressor patients whose blood virus level is so unusually low it typically cannot be detected by standard tests.

In these patients, Connors says secreted proteins do not seem to be responsible for the protection. "We've tested for many proteins and drilled a lot of dry wells for a number of years," he says. "So we're happy we found this."

What Connors and his colleagues found was that the CD8 T cells in his extreme group of patients started replicating rapidly in response to HIV-infected cells, while that was not true in patients in which the disease had progressed.

Intriguingly, as the cells started multiplying they also switched on proteins for attacking virus-laden cells. That suggests that if the cells do not multiply, they are not properly primed for battle. Now the researchers are investigating how the CD8 cell's replication ability is closed down in most HIV-positive patients.

This is an important question since the majority of vaccine strategies against the virus are meant to stimulate the killing function of CD8 T cells. "Ideally the vaccine would prevent that phenomenon we see in progressors," Connors says. "And in infected patients, we'd like to reverse it."

[Archie Bunker on steroids]

The planet is probably investing 30 times more into AIDS research than all other lethal diseases combined. Had we poured that kind of money into cancer, it is unlikely that people would have to suffer through chemo & agonizing death.

Amazing, a disease that can be prevented by proper behavior choices.

[Neuromancer]

For more that four years I have been posting breaking news from the world of Virology on Free Republic.

Is there now a new rule that bars medical or scientific news from the sidebar?

Regards..

[okiedust]

You are of course correct about the behaviour component of AIDS as a disease, but the research into the mechanisms of immunology can benifit a host of diseases. Look at it this way, while it is a vile and avoidable social disease with a politically correct base of funding, like many things it can carry an unexpected bonus in knowledge which will far surpass the original objectives of the research.

regards

[Endeavor]

Okiedust has it right. What we are learning about the immune response via AIDS research is leading to developments across the human disease spectrum.

That said, would that we could have bypassed the AIDS situation, but life is not that simple.

[alloysteel]

AIDS would not wipe out the human race completely even if we were all fornicating like minks in heat with every available partner, because in the normal range of human variations, there are some natural immunes. Not enough, perhaps, for a viable human culture to survive, which would cause a new and very Dark Age to descent on the planet, but individual pockets would grow up and form the nucleus for a new civilization to be born. But wouldn't just kind of waste the last couple of dozen millenia?

[Archie Bunker on steroids]

I agree. AIDS research potentially can help in other areas of immunology & cancer/virus research. Its the motivation & politics behind the research that disturbs me. Cancer research will directly help more people & perhaps bust down more doors in other areas including AIDS.

Unfortunately, we will never put the same resources into the afflicition until it becomes the result of gay behavior.

[Neuromancer]

You are, of course, correct but our attempt to understand these LTNP's is central to the development of a successful vaccine.

Because this retrovirus is highly prone to mutation we might be better to err on the side of extensive research vs/ rolling the genetic dice..

[JasonC]

"if the cells do not multiply, they are not properly primed for battle."

Or that the patient's immune system is suppressed by factors tangential to the present of HIV.

"investigating how the CD8 cell's replication ability is closed down in most HIV-positive patients."

I would be seriously interested in the immunological evidence behind the "most" in that sentence. Because I have a hunch it may have been pulled out of somebody's tailbone, and that actually they flat do not know how many are in the one category, and how many are in the other.

The old song that everyone that becomes infected with HIV virus will eventually develop full blown AIDs and die from it (which always had a bit of scaremongering whiff to it, perhaps defensible from the standpoint of prevention - I mean, it does not happen that way with most other fatal infectious diseases), has not exactly been born out by more recent facts. Great that anyone is horning in on why. But it might be a little more honest to present the puzzle along with this sort of discovery, side by side.

[buffyt]

You are 100% correct! My teenage son said the same thing. People who get breast cancer sure wish they could have just avoided bad behavior to avoid cancer......

[StopGlobalWhining]

He is working with a subset of nonprogressor patients whose blood virus level is so unusually low it typically cannot be detected by standard tests.

What does this say about the risk of getting AIDS from a blood transfusion? If the Red Cross and other blood providers perform the "standard test" on donors, and are unable to detect HIV or LAV in the blood of such "nonprogressors", then that would seem to pose a BIGexposure to AIDS infection.

[concerned about politics]

blood virus level is so unusually low it typically cannot be detected by standard tests.

And goes into Americas blood supply. How nice.

[concerned about politics]

Had we poured that kind of money into cancer, it is unlikely that people would have to suffer through chemo & agonizing death.

That's what I was thinking as I read the article. Cancer is not volentary. Cancer patients are really victims.

[mamelukesabre]

Here are my thoughts on the subject.

I have read that there are actually alot of people that are totally immune to aids and even more that are "somewhat" immune to aids. I am relying on my memory and I read this in a medical journal at the university library. As I remember, the numbers were something like 10 percent of white europeans are immune and an additional 15 percent or so have a "partial" immunity. The numbers for the other races of the world are practically zero. In north america, there numbers are somewhere inbetween.

Now here's what doesn't make sense to me.
IF africa has the largest population of people engaging in risky behavior, shouldn't Africa have the greatest percent of genetically immune individuals?

[concerned about politics]

Because I have a hunch it may have been pulled out of somebody's tailbone,

Well.....that's where it could have come from, you know. Literally.

[Neuromancer]

The sad history of PC in the AIDS pandemic is all too true. Many fought for normal STD protocols in the early stage of this disease. Contact tracing and screening might have saved many lives..

I will not defend the funding of AIDS nor lung cancer research. However when we strive to eliminate the pain and suffering of those who are weak and imperfect - we glorify God.

[illbenice]

"Amazing, a disease that can be prevented by proper behavior choices."

Not always, my grandpa and three of his brothers died of aids. Their only crime was having hemophelia and needing blood.

[Neuromancer]

As you point out these numbers are rather ethereal, however as a rule of thumb the group of people, known as long-term non-progressors — amount to between one and two percent of HIV-positive people in the United States

[JasonC]

Since they aren't a "long term" non-progressor unless they have not developed AIDs after being HIV positive for an extended period, comparing them to all HIV positive people in the U.S. doesn't exactly tell you anything. Because many HIV positive people haven't been HIV positive long enough to enter the category - while others progressed, but are no longer alive. It is an apples to oranges ratio. Most HIV positives who do not have AIDs aren't "long term non-progressors" - nor are they "long term progressors" i.e. people with AIDs (the last is a small population, and one that does not stick around terribly long). They are neither-nor, simple HIV positives. Also, the U.S. is hardly the only population of interest.

[Greybird]

So, it appears, some homosexuals are not going to die (or as soon) from "God's curse."

Boy, is THAT news going to ruin the day of a lot of FReepers.