Can the Body Control HIV Infection without Drugs? Early Findings Suggest That Intensive Early Treatment May Arm the Immune System against the AIDS Virus

Article excerpt

The patient had stayed home from work one day three years ago because he thought he had the flu. But as he read a front-page article in a Boston newspaper, he got worried. The article described a flulike syndrome that people develop shortly after contracting HIV. It's often the only symptom an infected person shows until years later, when the immune system falters and the first signs of AIDS appear. So the patient decided to get tested for the virus. The results confirmed his worst fear--he tested positive--but there was one small consolation. Researchers at Massachusetts General Hospital were investigating a new strategy against HIV. They wanted to know whether treating people intensively during the earliest phase of infection might ultimately enable them to suppress the virus on their own. Most folks are well beyond the flulike "acute phase" of HIV infection before they learn they have a problem. Because this patient acted on his suspicion, he was perfect for the study.

He must be glad he joined. The researchers reported their initial findings in the journal Nature last week, and they're utterly tantalizing. By starting treatment early, and interrupting it for brief periods once they had the virus under control, all of the study's eight participants were able to bolster their immune responses. Indeed, five of the eight have now been off treatment for periods of eight to 11 months--and their infections are still well under control. The study was small, and the results are preliminary, but, says Dr. Bruce Walker of Mass General's Partners AIDS Research Center, "we now have proof of principle that the immune system can get the upper hand against the virus."

HIV ravages the immune system's so-called T-helper cells. Despite their name, these cells are the generals responsible for mobilizing other parts of the immune system against infection. They put up a good fight at first, creating a large army of "killer" cells (cytotoxic T-lymphocytes) that seek out and destroy cells infected by HIV. But as HIV replicates year after year, the immune system wears down and eventually collapses. Combinations of powerful drugs can handcuff the virus for long periods, but it typically roars back into action as soon as a person stops taking them. …