‘Shock And Kill’ Strategy To Cure HIV Could Damage A Patient’s Brain

First Posted: Dec 07, 2016 03:40 AM EST
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Scientists and medical researchers have found success in the long-term control of the spread of Human Immunodeficiency Virus (HIV) in a patient's body through different combinations of drug treatments. One effective way that scientists are using is the combination of a "shock and kill" strategy and antiretroviral therapy (ART). However, a recent study warns that the "shock and kill" strategy used to find a cure to HIV could damage a patient's brain.

In a news release on Science Daily, a team from Johns Hopkins University School of Medicine warns that the use of "shock and kill" strategy to wipe out HIV cells in the body could damage the patient's brain. The root of the problem lies in the ability of HIV cells to hide and remain undetected for long periods of time and the use of the "shock and kill" strategy.

In a "shock and kill" strategy doctors shock or force the hidden HIV cells to wake up or become active HIV cells. The now active HIV cells are then killed through various treatments using antiretroviral medicines.

Herein lies the problem where the doctors must ensure that the now active HIV cells would not spread or become active in the brain and that all traces of HIV, active or dormant cells, are completely wipe out from the patient's body. If ever the active HIV cells spread in the brain, the succeeding treatment to wipe out the HIV cells must not infect or damage it.

In order to prove the effectivity of the "shock and kill" treatment as a cure for HIV, the team from Johns Hopkins University infected three pig-tailed macaques with HIV's cousin, Simian Immunodeficiency Virus (SIV). Two of the macaques were injected with drugs to wake up the SIV cells and coupled these with a cancer medicine that made the monkeys' immune system vulnerable to SIV. The doctors also continue treating the macaques with ARTs.

After 10 days of the combined treatment, one monkey remained healthy while another one developed symptoms of encephalitis or inflammation of the brain. According to Dr. Lucio Gama, tests were conducted on the sick monkey and found it also has an active SIV infection. The monkey with the active SIV infection and encephalitis was humanely killed after its condition continued to deteriorate.

The blood from the infected monkey was carefully removed so as not to contaminate the brain. The team from Johns Hopkins University found out that the SIV infection was still active on the monkey's brain -- but only on the occipital cortex part of the brain. Dr. Gama said that the SIV reservoir in the brain was so small the team almost missed it.

The results of the study published in the Jan. 2 issue of the journal AIDS concludes that although the study was conducted on macaques, there is possible implication that the same can happen with human HIV patients. The doctors warn that an extra precaution must be to ensure that whenever the "shock and kill" strategy is used, all the HIV cells, whether active or dormant, must all be eradicated from the body.

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