Miranda Smith
HIV still replicating in tissue in people on ART
Research published this month in Nature suggests that ongoing HIV replication is responsible for maintaining a virus stockpile in lymphoid tissues even when treatment makes the virus undetectable in blood.
Taking sequential viral sequences from blood and lymph nodes in three patients on ART, Lorenzo-Redondo and colleagues looked at the genetic code of the virus and showed that it changed over time and that the viruses were different in blood and the lymphoid tissue. Poor diffusion of antiretroviral drugs into lymphoid tissue is thought to enable viral replication and this study suggests that if uptake of the drugs is patchy, then not only can the virus replicate, but drug resistance won’t develop. The study also suggests that ongoing HIV replication in lymph nodes feeds virus back into the bloodstream, so that even when treatment is effective in blood, there is a small but steady stream of new virus to deal with.
While only sampling a small number of patients on ART for 6 months (two of whom were in the early months of HIV infection), these new results provide some intriguing evidence for ongoing replication of virus on ART and suggest that new research will need to focus on targeting ART drugs to tissue.
See here for the full article.
For the NIH press release, see here.
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