Oxford study could point to new treatments for HIV

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Children display ribbon cut-outs tied to balloons during an HIV/AIDS awareness campaign to mark World AIDS Day in Kolkata December 1, 2014. The world has finally reached "the beginning of the end" of the AIDS pandemic that has infected and killed millions in the past 30 years, according to a leading campaign group fighting HIV. United Nations data show that in 2013, 35 million people were living with HIV, 2.1 million people were newly infected with the virus and some 1.5 million people died of AIDS. By far the greatest part of the HIV/AIDS burden is in sub-Saharan Africa. REUTERS/Rupak De Chowdhuri (INDIA - Tags: HEALTH SOCIETY) - RTR4G8WJ

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HARI SREENIVASAN, PBS NEWSHOUR WEEKEND ANCHOR:  This week, Oxford University researchers released a study that may point to new treatments for people infected with HIV, the virus that causes AIDS.  The study looked at young children in South Africa with HIV and found that 10 percent of them never develop symptoms of AIDS.

To discuss the implications of this study, I’m joined via Skype from Oxford, England, by Philip Goulder, a professor of pediatrics at Oxford University, who led the research team.

So, Professor, what do these children have that’s special?  How is it they don’t go from HIV to AIDS?

PHILIP GOULDER, OXFORD UNIVERSITY:  Well, the interesting thing about these children is that, as you say, they don’t progress to the disease through childhood.  And children in general with HIV progress much more rapidly than adults, something like 60 percent without treatment would die in the first two and a half years.

So, this is quite an unexpected finding.  And we initially looked to see whether this was to do with the immune responses against the virus.  And in fact, although they do make quite strong immune responses against the virus, this wasn’t the reason they didn’t progress.  But the reason was that they, in spite of having a lot of virus onboard, their immune activation levels are relatively low.  So in some senses, they tend to ignore the virus, and as a result, they don’t get any disease from it.

HARI SREENIVASAN:  That’s the opposite of what an adult body would do, right?  I mean, it would try to — our body would attack as much as possible, and you’re saying the sort of the peace versus the war might be better in these cases?

PHILIP GOULDER:  Exactly so.  The immune system has a very difficult job on its hands, because if you make too weak a response, you run the risk of being killed by a foreign invader, and if you make too strong a response, then the immune response causes a disease on its own account.  So, finding that perfect middle line is a very difficult thing for the immune response and, obviously, the immune system has to deal with all sorts of different pathogens and handle those.  And HIV is just one particular virus that it has to deal with.

HARI SREENIVASAN: Will these children be safe the rest of their lives?  Will they not develop AIDS?

PHILIP GOULDER:  We think some of them, as they transition from childhood into adolescents and adulthood, actually do start to make the sort of immune responses that are characteristic of adults.  In other words they start to try and fight with the virus.  And although that tends to bring the virus down, unfortunately, the bad side is that the immune system gets more and more activated, and actually, they progress more rapidly.

On the other hand, there are still some who can reach adulthood and still remain nonprogressors.

HARI SREENIVASAN: Tell us, what does this teach us, what does this teach medicine or even the pharmaceutical industry?  Do we change our strategy or our approach?  Do we try to build different kinds of drugs in the future that tries to mimic what these children are doing naturally?

PHILIP GOULDER:  I think so.  I think we can actually learn a lot from what children can teach us in the different way that they approach dealing with foreign pathogens like HIV, and in this instance, obviously, antiretroviral therapy is the mainstay of treatment for the people with HIV, and, you know, the prognosis for people with HIV has been transformed by antiretroviral therapy.

That being said, the immune response of people with HIV doesn’t return to normal, even with successful treatment.  So, there is still a need per new approaches to try to bring the immune system back to normal so that people with HIV, even on treatment, don’t run risk of so-called non-AIDS-associated diseases like cancers and cardiovascular disease, to which they’re at risk.

HARI SREENIVASAN: Philip Goulder, professor the pediatrics at Oxford University — thanks so much for joining us.


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