January 19, 2010- A multidisciplinary research team at the Johns Hopkins University School of Medicine has been awarded $8 million in funding by the National Institutes of Mental Health to develop methods to rid the body of HIV.

“While highly active antiretroviral therapy has been effective in reducing morbidity and mortality by decreasing the incidence of AIDS, HIV infected individuals on HAART (highly active antiretroviral therapy) do experience cognitive impairment, probably due to latent virus persisting in the nervous system,” says study leader Janice Clements, Ph.D., professor of comparative and molecular pathobiology at the Johns Hopkins School of Medicine. “We have developed a model that mimics what is observed in HIV-infected patients on HAART and plan to use it to better understand how HIV infection causes nervous system problems.”

HAART can reduce HIV levels to below detectable numbers. But, some small amounts of virus evade drug therapy and stay inactive in a so-called latent form, in immune system cells. Previous research by this team has shown that primates infected with their version of the virus, SIV, and treated with HAART also harbor residual virus in the central nervous system.

“HAART is not a solution to the AIDS epidemic — it is only a step towards eradication,” says Robert Siliciano, M.D., Ph.D., a professor of medicine whose lab also is part of this effort. “Our next challenge is to find a way to purge the body of infection and clear the reservoirs of virus from the deepest recesses of the body, including the brain.”

Because viral reservoirs are difficult to study in people, the team already has developed an SIV model of HAART therapy in HIV-infected people that combines four drugs and reduces viral load in the bloodstream and spinal fluid to undetectable levels. Using this model, they plan to pinpoint the best time to start HAART treatment to protect the immune system and the central nervous system from virus-induced damage, and to what degree the virus or HAART therapy causes damage to the peripheral nervous system. They also plan to figure out if it’s possible to rid tissues of residual virus using new drug therapies.

“This is a real first for us, bringing together from all over Hopkins, immunologists, virologists, pathologists and molecular biologists, with expertise in HIV research and treatment, SIV pathogenesis and viral immune response,” says Clements. “We are thrilled and incredibly grateful to have such support from the NIH to pursue this critical research.”

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