Brain missing link to HIV cure

Brain missing link to HIV cure

Scientists have discovered the brain plays a much larger role than first expected in harbouring HIV — a finding which may prove vital finding a cure using all-over-body eradication.
Research from Melbourne’s Burnet Institute has revealed brain cells called astrocytes have shown up as sustaining extensive damage in patients with HIV-associated dementia.
Burnet Institute lead researcher Dr Melissa Churchill told Southern Star the finding was significant as astrocyte infection in HIV patients has previously been considered low-risk when a person is treated with antiretrovirals.
“Previously the level of infection in the brain was thought to be much lower, probably 1-to-2 percent of cells affected, but it’s shown it can be up to 19 [percent], and because of the massive number of cells that actually represents, the amount of virus or potential virus in the brain is quite high,” Churchill said.
The research follows a global shift in HIV research from developing a vaccine to eradicating it, ‘curing’ HIV by targeting ‘viral reservoirs’ or areas of the body where HIV is stored.
Astrocytes are the most abundant cell type in the brain and are critical for normal brain functioning. It’s now thought HIV-infected astrocytes are likely to cause brain neurons not to function, causing dementia in HIV patients.
The most common incidence of dementia in people under the age of 40 in Australia is in HIV-positive people. Available drugs are so far inadequate in treating HIV in the brain.
The five-year Burnet study, conducted in conjunction with Monash University, St Vincent’s Hospital in Sydney and Baltimore-based Johns Hopkins University, provides insights into understanding HIV-associated neurological disorders.
Churchill said clinicians may have previously overlooked the brain when trying to stimulate the virus in other areas of the body to eradicate it and treatment strategies may now need a rethink.
“We have to be more conscious that there’s a burden of virus in the brain which has been underestimated in the past,” she said.
Churchill said the finding should encourage research in developing antiretrovirals which can effectively tackle the virus in astrocyte cells without further damage to the brain.
St Vincent’s Hospital head of neurology Professor Bruce Brew said the finding was a significant step forward for future methods in attacking the virus in infected areas.
“It is potentially another explanation for the continuing presence of cognitive impairment in antiviral-treated patients, as the efficacy of current antiviral drugs in astrocyte infection is limited at best,” he said.
The finding was published in August in the scientific journal Annals of Neurology.

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