The Human Immunodeficiency Virus, shortly refereed as HIV, has been a reality for many years now. Although the virus was recognized in the early eighties, it is believed that it emerged much earlier, in the 1950s. Many people are wondering why effective control methods are unavailable after all these years. We have to remember how long it took us to solve other challenges such Smallpox or Poliomyelitis. Yet still, nowadays we have more advanced technology at our disposal. Why are we unable to bring this to an end? Even as the knowledge and technology advance, things still take time. Today, there are more questions to answer than in the past, more challenges in offering a quality healthcare service.
The latest developments in HIV research are always in media spotlight. This is maybe the most investigated healthcare subject. A lot of scientific research is concentrated around the subject, sometimes more than we can keep up with. This is very encouraging for the scientific community. Recent study results are interesting and hopeful. The major recent achievements that could have a real benefit are the advance in laboratory diagnostic and therapy.
The diagnosis methods used until recently had limitation, meaning that they unable to diagnose the infection in early stages. The recent fourth generation diagnostic tests are able to diagnose the infection in early stages before seroconversion. Briefly, this means that the infection can be revealed two or three months earlier than before. Two major benefits result from this: an enhanced control of spreading out of the disease and the possibility to begin the treatment in the early stages of the infection, which can result in better outcome. Starting the treatment months earlier could make a significant difference, since skipping the ideal moment for starting the treatment seems to be the major drawback in the currently available therapy.
In its complex pathogenic mechanism, the HIV pro virus DNA ”hides” itself by integrating in the cell’s genome. The virus has capacity to remain in a latent form and the replication is put to a hold. There, it can remain undetected (which explains the apparently “cured” cases) and untargeted by the antiretroviral therapy (ART). Certain stimuli can release the virus from latency and start the replication again, which leads to the symptoms recurrence. Complete cure means the complete elimination of any viral component from body, and could be achieved only by excising the viral DNA already integrated in the host’s genome. The current available therapy, concentrated only on inhibiting the viral replication, is unable to accomplish this and provide the complete cure.
A Chinese team conducted a study concentrating on precisely the excision of the viral DNA segment from the human T cell genome. For this purpose, specially designed zinc-finger nucleases were produced. They were designed to recognize and excise the HIV pro virus DNA from T cell genome. The rate of excision was 45.9% and the process was not showing any significant toxicity. Although it was an in-vitro study, the results were encouraging and demonstrate the possibility for an alternative approach in HIV therapy, which can lead to the complete cure.
These recent developments show a clear and undeniable progress, and open paths for new studies. It is clear that a novel approach has to be used. The only question is which one will be successful in the end.
Will it be pro virus excision? Could this new technology be able to remove other unwanted sequences from our genome?