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HIV may be eliminated from reservoirs of infection in the body

BMJ 1997; 314 doi: (Published 17 May 1997) Cite this as: BMJ 1997;314:1433

The last few weeks have seen the publication of some exciting research on drug treatment for HIV, as Luisa Dillner reports

HIV-1 could be totally eradicated from CD4 T cells and lymphoid tissue by a combination of antiretroviral drugs, claimed two research groups in Nature and one in Science last week.

David Ho and his team at the Aaron Diamond Aids Research Center in New York used a mathematical model to predict that drug treatment that is completely inhibitory could eliminate within 2.3-3.1 years the virus from the plasma and reservoirs of infection such as tissue macrophages and latently infected lymphocytes (Nature 1997;387:183-7).

The characteristics of HIV-1 decay were studied in eight patients who were given nelfinavir, a protease inhibitor, and zidovudine and lamivudine, two reverse transcriptase inhibitors. Both drugs block enzymes encoded by the virus. Reverse transcriptase inhibitors block the enzyme that converts the viral RNA into DNA in the host cell, and protease inhibitors prevent the cleavage of proteins in the newly formed virus particles.

Dr Ho and his team found that within two weeks of treatment the concentration of HIV-1 in plasma dropped by 99%–largely as a result of the rapid elimination of free …

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