In recent days, the forums, Leon brought an article by Brennan et al. (Silicon it is mentioned only because it is famous, but I think he contributed very little ...) on the determination of the HIV reservoir. The article was really
monumental (11 pages), so it took me a while 'to translate it. with the help of two colleagues forum (Dora & Gexgex), the translation was made in good Italian and added some 'useful comments (not to me, so that there is nothing I will understand the same).
In short: What does the articolone? Here is a summary stringatissimo:
Success in high-activity antiretroviral treatment (HAART) of HIV reduces the free virus in the blood to undetectable levels by the most sensitive clinical test. However, HIV persists as a latent provirus within resting memory CD4 and possibly other cell types.
The first claim of the authors is that the provirus present in circulating activated and resting CD4 cells belong to a mixed population, ie that the provirus of the CD4 part of the "family". Unfortunately, there's a surprise: the data of tests conducted on the genetic structure of the various samples suggest that the residual viremia (virus in the blood free) includes one or more genetically distinct viral populations from provirus in resting CD4 + T cells.
This study, like others that preceded it, has some problems: first, the virus samples were obtained at different times, which does not mean that the virus itself "deceive us' with its mutations, Furthermore, these samples, the effectiveness of HAART accomplice, they are really small, and therefore (to speak by butchers) give too little material to work with, and the risk of error is amplified (an error in a hundred is 1%, a is an error on the 100%).
There was only one patient ("Patient 154") for which the quality and quantity of samples was such as to allow a "reliable", that had a good amount of active virus (ie without errors) to be able to compare with the virus of residual viremia. And the analysis showed that in this patient, the plasma virus was significantly different from the provirus derived from Is activated and resting CD4.
The study of this patient that would indicate that there are two distinct populations of virus. That the majority of plasma virus may be derived from some sources still unidentified cell has several important clinical implications regarding the management of HAART to treatment failure, the propagation of viremia associated with discontinuation of treatment and strategies aimed at eradication.
Several laboratories are actively following several eradication strategies, most of which includes a number of cleanup activities and target the latent reservoir in resting memory CD4. If most of the residual viremia in patients treated with HAART had been from other reservoirs or compartments, as suggested here, then, to be effective eradication strategies should include ways to target and clear out these other reservoirs.
The full translation of the article is on Google Docs: from which you can also download the PDF. Instead the forum
there are comments.
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