HIV Protein Image May Be the Next Step Toward a Vaccine

A boost to the war against HIV would be to produce an effective vaccine. Over the decades, research has continued to provide promising strategies for disengaging the viral attack on a host. However, much of this research comes to a halt when it comes time to implement the information. The reason for this standstill has to do with the actual physical makeup of the virus. Creating an antibody has proven not to be out of the scientists’ reach, but getting that antibody to stick to the virus has.

Next Step Toward a Vaccine

In order to neutralize the invading virus, the antibody must attach itself. HIV is so well protected that this has proven futile. In an effort to see vulnerabilities in the viral membrane, researchers have tried to get a closer look at some of the external parts that are attached to the membrane. For years, this also seemed out of reach. Many of the proteins that are attached to the virus are delicate and unstable. Attempts at capturing the image resulted in breaking the structure because of its fragile nature. This losing streak, though, just came to an end. Finally, a high-resolution image of a key protein on the outside of the viral wall has been taken. Now, scientists will be able to study the segment and see what approach to take so that antibodies can adequately attach themselves.

This protein is not only a vulnerable part of the virus, but it also happens to be very consistent among various strands of HIV. In other words, it does not mutate as much as other structures. This means that when a vaccine is produced with antibodies that can attach to this protein, it should be able to cover a vast array of HIV infections. There will be no need for multiple vaccines. Also discovered is that while this would be an ideal site to neutralize the virus, there is a shield around it. This sugar-like substance conceals the area and will make contact difficult for antibodies. Taking a closer look at these molecules will help researchers break down the defense so that the immune system can do its job.

Immune Exhaustion and HIV

HIV infection has long been known to cause immune exhaustion. Even with current therapies, this is a chronic issue. Finding ways to lessen the burden on the immune system, while still keeping the virus at bay, have been studied. Recently, some new experimental treatments have brought to light some interesting conclusions on the matter. It is hoped that the information thus gathered will help control the problem for many in the near future.

What the Research Reveals About Immune Exhaustion

Delicate balances keep everything in existence – from the largest systems to the smallest organisms. The interactions between the medications that keep the HIV counts low, the immune T cells, and the proteins that signal immune exhaustion are extremely precise and particularly balanced. Researchers have studied the effects of blocking the protein pathways, which are known to signal the exhaustion. In doing so, they have discovered that people can recover from immune exhaustion. However, a number of things must be in place for this to happen.

The exhausted T cells are the ones that have the protein, PD-1, which signals the exhaustion. The partner to that protein binds to it, and this is how researchers can identify the exhausted cell. By blocking the path between these two proteins, the immune system has a chance to regain normal function.

A Very Specific Process

When tested, this strategy was effective, but only under specific circumstances. First, if viral levels in the blood were high, adding the protein blockade actually increased viral production. Best results were yielded when the viral load was low. Also important is how the T cells react, as their numbers also increase. However, with low viral load and cooperating immune cells, restoring a measure of strength back to the immune system is possible with this method.

Further testing is underway, as are trials to see just how effective this approach can be. Of course, if implemented in the future, patient screening will be necessary. In the meantime, antiretroviral therapies continue to be an important part of both managing viral count and slowing disease progression.

Potential Key to a Cure for HIV

Antiretroviral therapies are efficient at lowering HIV levels in the blood. They suppress these levels enough that the virus can become virtually undetectable, making it hard to cure. While this provides the patient with a measure of health, and also slows disease progression, it is not enough to completely eradicate the virus from the body. Why is this the case? What is the key to eliminating the tenacious invader completely so as to have a cure?

Progress Towards a Cure

Study after study continues to show that antiretroviral therapy alone cannot completely rid the body of HIV. It is true that low viral levels within the blood can prove lifesaving, but HIV finds a way to hide, replicate, and even thrive. Attempting to kill off the virus in these areas is the key to completely wiping it out. Blood levels can be kept low because the drugs can effectively work within the vascular network. Researchers are finding that stores of HIV are located within the lymphatic system, specifically in lymph nodes and like tissues.

This presents challenges for healthcare. One, it is difficult for pharmaceuticals to reach the specific tissues where the virus replicates. It is rare for medications to filter into these lymph nodes. Also, there is the matter of viral mutation. As HIV patients increase in numbers, changes in the disease’s resistance to drugs begins to appear.

The good news is that usually it is the non-resistant form of the virus that hides and replicates. Once it releases into the blood, the drug therapies are still effective. Also, when researchers exposed the infected tissues to the drugs, the infection could be cleared. However, depending on the type and concentration of the drug therapy, the amount of drug-resistant HIV can fluctuate, making things complicated.

Further investigation is underway about how to infiltrate lymphatic tissue in order to remove stores of HIV. Researchers are convinced that once they gain a better understanding of how to reach these areas—combined with antiretroviral therapies—a cure for HIV will be at hand. Until then, daily treatment is the only way to keep the disease from progressing.

Making HIV Testing Acceptable to Patients

Around the globe, 37 million individuals are HIV-positive. While that figure is staggering enough, it is estimated that nearly half of all infections are left undiagnosed. Advancements in therapies, preventative education, and a better understanding of how the disease works, all aid in slowing the epidemic. However, if the infection is left undiagnosed, it works against progress, and millions could be at risk for exposure or infection.

With this is mind, researchers have been looking into simple ways to encourage patients to be tested for HIV. They are hoping that what they learn will help medical institutions around the world to be able to convince more people to agree to screening.

Asking Patients the Right Way

It is all in the approach. This is what has been most notable throughout these studies. How a question is phrased can make the difference between someone agreeing to HIV testing—or refusing the exam. Basically, here are three ways to approach:

  • Notifying the patient that testing for HIV is available, and that he or she could request the test if they wanted (also called the opt-in approach). This approach yielded the poorest result, with just over one-third of those asked accepting an exam.
  • Using the “active choice.” In this instance, a patient was asked directly if he or she would like an exam. This second phrasing came up with better results than the first. Over half of the patients who were asked directly, agreed to the testing.
  • The “opt-out” approach simply informed patients that they would be tested for HIV unless they declined. Two-thirds of those who were informed this way were tested, making this approach the most successful.

The Right Method Gets Results

During these trials, patients who were in higher risk categories were more likely to agree to testing than those in lower risk groups. This reaffirms that how a patient is asked can make a big difference in the outcome. It is not completely understood why patient behavior varies with how questions are phrased, but a few simple changes in how healthcare workers ask their questions can do a lot of good.

Protein HIV Used to Hijack Human Genes

Four years ago, it was estimated that 1.2 million people living in the United States had HIV. Add to that an average of 50,000 new cases per year, and the results are staggering. As the disease progresses into AIDS, the outlook is bleak. One estimate put the number of patients with the advanced stages of HIV at over 26,000. While it is true that therapy can give a person who is HIV-positive a promising future, these treatments are lifelong, and the effects of the infection still manifest themselves in different ways as a patient ages.

A Protein Called Tat

In order to better understand how this wily virus is able to get such a strong hold on its host, experts meticulously performed experiments and studies. The results have brought to light how HIV uses a tiny protein, called Tat, to shut down certain human genes. HIV (a retrovirus) does not have many of its own genes, which is why it searches out and eventually takes over a host cell’s genes. Here is where the small protein, Tat, comes in. Once the command center of the cell has been overtaken, Tat manipulates the genes in order to create a more appealing environment for the virus. Studies show that nearly 400 human genes bind with Tat—and then shut down. When the scientists compared the symptoms of an HIV infection to the genes that were shut down, the two were compatible.

What this tiny protein is able to accomplish is astounding. It does provide useful knowledge that could be applied to halt infection and keep the disease from progressing to AIDS. One European country has already begun working on a vaccine which inhibits Tat in order to try and stop HIV. The results have been promising. However, it will take some more time for anything concrete to be established. In the meantime, more information is being gathered and used to come up with even more effective ways to treat, prevent, and hopefully completely eradicate HIV in the future.

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