AIDS Treatment Update, Issue 58, October 1997
Edward King

The two individuals started treatment with the combination of ddI plus hydroxyurea (see AIDS Treatment Update issue 26) within a year of becoming infected with HIV; even before treatment, their viral load was extremely low at 676 and 1120 copies/ml respectively. After 12 months' treatment, no HIV part icles could be detected in their blood or in samples from their lymph nodes. They stopped treatment but even after a year without any therapy, HIV particles were still undetectable in their blood and lymph nodes.

Very low levels of proviral DNA - which indicates the presence of HIV-infected cells - could be detected in their lymph nodes both when they stopped treatment, and one year later. However, all attempts to stimulate these cells to produce infectious HIV in the laboratory failed, suggesting that these cells may be harbouring defective pieces of HIV's genetic material. For more information on proviral DNA, see AIDS Treatment Update issue 50.

The report is consistent with theories that in some cases, anti-HIV therapy may be able to eradicate the virus from infected people - although it remains to be seen whether infectious HIV has indeed been eradicated from these individuals. They were remarkable in that their viral load was so very low prior to treatment. This raises the possibility that these individuals could have been long-term non-progressors anyway, even if they had received no anti-HIV therapy.

Vila J et al. `Absence of viral rebound after treatment of HIV-infected patients with didanosine and hydroxycarbamide`. Lancet 350(9078): 635-636, 1997.

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