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to Section One | to Arts & Entertainment
posted Friday, December 5, 2014 - Volume 42 Issue 49
'Mild' form of HIV evolving, Brit scientists say
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'Mild' form of HIV evolving, Brit scientists say

by Mike Andrew - SGN Staff Writer

HIV is becoming less infectious and less virulent as it evolves, a major new study reveals.

Scientists at the University of Oxford in Britain say that as the virus evolves, it takes longer to replicate itself, and therefore it becomes less easily transmitted to new hosts. It also takes longer for HIV infections to become symptomatic.

The findings, published on World AIDS Day in Proceedings of the National Academy of Sciences, suggest the global struggle against HIV infections may have reached a tipping point.

The research team reached its conclusion by comparing the progress of HIV infections in Botswana, which has dealt with the HIV epidemic for a long time, and South Africa, where HIV arrived a decade later.

'It is quite striking,' University of Oxford professor Philip Golder told BBC News. 'You can see the ability to replicate is 10% lower in Botswana than South Africa and that's quite exciting.

'We are observing evolution happening in front of us and it is surprising how quickly the process is happening.

'The virus is slowing down in its ability to cause disease and that will help contribute to elimination.'

When HIV enters a person's bloodstream, it is attacked by the host's immune system. The virus mutates to meet the challenge, and in many cases is able to overwhelm the host's defenses and replicate itself unchecked.

Sometimes HIV infects someone with a particularly effective immune system, however. Previous research on HIV has shown that a human gene known as HLA-B*57 provides a protective effect against HIV.

'[Then] the virus is trapped between a rock and hard place, it can get flattened or make a change to survive and if it has to change then it will come with a cost,' Goulder explained.

The 'cost,' he added, is a reduced ability to replicate itself. The scientists found that in Botswana, HIV has evolved to adapt to HLA-B*57 more than in South Africa, so patients no longer benefited from the protective effect. But they also found that the newly evolved strains of HIV had a significantly reduced ability to replicate - making it less virulent.

The virus therefore becomes less infectious and less able to destroy the host's immune system and invite opportunistic diseases.

'HIV adaptation to the most effective immune responses we can make against it comes at a significant cost to its ability to replicate,' Goulder said. 'Anything we can do to increase the pressure on HIV in this way may allow scientists to reduce the destructive power of HIV over time.'

The scientists then analyzed the impact of antiretroviral drugs on HIV virulence. Using a mathematical model, they found that treating the sickest HIV patients accelerates the evolution of HIV strains with a weaker ability to replicate.

The result is that patients can have significantly more time before HIV becomes symptomatic.

'Twenty years ago the time to AIDS was 10 years, but in the last 10 years in Botswana that might have increased to 12.5 years, a sort of incremental change, but in the big picture that is a rapid change,' Golder noted.

'One might imagine as time extends this could stretch further and further and in the future people being asymptomatic for decades.'

The group did caution that even a watered-down version of HIV was still dangerous, and that HIV-negative individuals should continue to avoid infection. But some scientists looked forward to the end of the HIV/AIDS epidemic.

'If the trend continues then we might see the global picture change - a longer disease causing much less transmission,' Professor Jonathan Ball, a virologist at the University of Nottingham, told the BBC:

'In theory, if we were to let HIV run its course, then we would see a human population emerge that was more resistant to the virus than we collectively are today - HIV infection would eventually become almost harmless.

'Such events have probably happened throughout history, but we are talking very large timescales.'

AIDS activists noted that for the first time in the epidemic's history, the annual number of new HIV infections is lower than the number of HIV-positive people receiving treatment, meaning a crucial tipping point has been reached in reducing deaths from AIDS.

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