United Press International - Friday, November 13, 1998
Mara Bovsun in New York City

Investigators at Philadelphia's Thomas Jefferson University say they found the hidden HIV, which they call a provirus, in the semen of four out of seven men who had responded well to aggressive drug treatment for AIDS. The men had no detectable free virus circulating in their blood or semen.

Dr. Roger J. Pomerantz, who led the research, calls this a fossil virus, which can hide in certain cells for years in a dormant state. The virus tucks its genetic material into the DNA of the cell.

Pomerantz says the provirus showed no sign of the genetic changes that occur to the virus after years of anti-AIDS therapy.

But his research, presented today in Denver at the annual meeting of the Infectious Diseases Society of America, has shown that given the right conditions, the virus can become active again. In his experiment, Pomerantz found that these proviruses will start to grow again in the laboratory when cultured with blood cells from people who were not infected.

Pomerantz says the proviruses can reseed the individual once drug therapy is stopped. Also, these dormant viruses can be passed on to another person, where they can cause a new infection.

This means that even if drug treatment seems to be working, HIV- infected men have to practice safe sex, says Pomerantz.

These men may not be as contagious as those with detectable virus, but they still pose a risk, he warns.

Scientists are trying to develop strategies for wiping out these last traces of virus. Pomerantz says it may take drugs to kill off the cells where HIV finds sanctuary, or treatments that activate the cells and the virus so the antivirals can do their job.

Pomerantz says he believes these lingering viruses will also be found in HIV-infected women who undergo this kind of therapy, which he calls HAART, or highly active anti-retroviral chemotherapy.

A related study at the Denver meeting found that in women, HAART was successful in sharply reducing the amount of virus in the genital, bringing it down to undetectable levels in more than half of the study participants.

Dr. Susan Cu-Uvin, a professor of obstetrics and gynecology at Brown University in Providence, R.I., says the study suggests that this kind of therapy may reduce the chances that a woman will transmit the virus during heterosexual sex, or to her baby during childbirth.

In her study of 176 women, about a third were getting the potent drug cocktails, a third were getting milder therapies and another third were taking no drug at all.

About 89 percent of the women on HAART had undetectable levels of virus in the genital tract, compared to 74 percent on less intense treatments and 67 percent of women taking no anti-AIDS drugs at all.

She says: "We would encourage every woman to go on HAART. Many women, however, do not want to take them, because the regimens are difficult, involving dozens of pills a day, and they can cause serious side effects."

Like Pomerantz, Cu-Uvin warns that women should continue to practice safe sex even if the drugs seem to have wiped out the virus. It may be undetectable, she says, but it doesn't mean it's not there.

She says, "It's not a cure."

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