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HIV Beats Researchers at Hide and Seek

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July 11, 2000 (Durban, South Africa) -- AIDS can't be beaten, top researchers from the U.S. say, but they are hopeful that they can find ways to make it easier for patients to live with the deadly disease that destroys a person's immune system.

Anthony Fauci, MD, one of the nation's health leaders who at one time believed we might be able to defeat the illness that now infects 34.5 million people worldwide, says, "It is now clear that eradication of HIV is not possible" -- at least not with any of the virus-fighting medications that are now available. Fauci, director of the National Institute of Allergy and Infectious Diseases (NIAD), addressed the medical community at the 13th International AIDS Conference.

"Therefore, one must turn to the long-term control of HIV," he says.

"We haven't achieved our objective of getting rid of the virus," agrees David Ho, MD, head of the Aaron Diamond AIDS Research Institute in New York and another prominent scientist battling against the disease that already has killed nearly 20 million people in the world.

Researchers had hoped that treating patients with cocktails of potent drugs -- a regimen known as HAART or highly active antiretroviral therapy -- would allow the body's defenses to be revived enough to seek out and destroy hidden reservoirs of the virus in difficult-to-reach places in the body.

The hope that HAART could wipe out HIV, Ho says, was based on two ideas, both later proved to be wrong: That, in the body, the drugs would completely stop the virus from reproducing and that there were no hiding places for the virus.

In 1996, researchers first tentatively mentioned eradication of the virus. At first it was estimated that two to three years of HAART, the current mainstay of therapy for patients with HIV, would be sufficient. But as doctors learned more about the disease, they realized their task would be more difficult. The estimated time to eradication of the disease increased to five years, 10 years, 23 years, and finally 60 years.

"The virus has the uncanny ability to reestablish a reservoir," Fauci says. "Even our most rigorous attempts to reduce or eliminate the reservoir had been unsuccessful."

Added to that, attempts to take patients off HAART regimens met with failure. The virus -- invisible to the best detection measures for three years or longer in some patients -- rebounded within a few weeks when the medications were stopped.

While admitting that a cure was not likely, Fauci says new efforts are being aimed at reducing the burden of constantly having to take handfuls of HAART drugs. For about the past two years, various studies have looked at periodically removing patients from their treatment. Fauci also has launched his own study, the goal of which is to allow the natural defenses of the body to keep HIV at bay -- although not eliminating the virus.

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