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celebrated the World day of fight against AIDS On the First of December. The day before Medpravda`s journalist met the executive director of the All-Ukrainian network of the people living with HIV Vladimir Kurpita and learned about new approaches to prevention and treatment of HIV - AIDS.

 

The virus hides in tanks

- Vladimir, you noted that in recent years in the field of treatment and prevention of HIV - AIDS there were shifts. There were many perspective developments which could liquidate infection epidemic over time. What did you mean?

- Recently I returned from the X International conference on questions of anti-retrovirus therapy which is held each two years in the city of Glasgow, Scotland. There very interesting facts sounded. Probably, you know that the preparations existing for today for treatment of HIV - positive patients do not delete a virus from an organism completely. The virus all the same remains in an inactive state in so-called reserve places where modern drugs can almost not get. It can be lymph nodes, lymphatic fabric of certain bodies, gametes. While the person accepts preparations, the virus hides in these tanks, does not get to blood, thus the illness does not progress. But as soon as the person stops accepting therapy, the virus is again activated and the illness renews. Therefore for HIV - positive people who began anti-retrovirus therapy it is extremely important to take medicine constantly, according to that scheme which was registered by the doctor and not to deviate from it.

- Means, a situation, how with diabetes - lifelong treatment? Considering the cost of preparations, prospect not from the best.

- It is inconvenient, but yet there are no other options. Though in different laboratories researchers try to create such drugs which could receive and neutralize HIV even in tanks and completely exempt an organism from a virus, occurs at other infectious diseases. By the way, in this direction there are already certain achievements. For example, the message about " was published a year ago; Berlin patient . HIV - the positive person, from proved to HIV - an infection, ached with a lymphoma. To save the patient`s life, doctors made to him a full bone marrow transplantation. Operation took place successfully, the lymphoma managed to be overcome. In half a year after this transplantation the patient came to planned inspection. And unexpectedly for all it turned out that in blood of the patient antibodies to HIV disappeared. Analyses remade not once or twice, but results confirmed: the person it was completely exempted from an infection, the organism was cleared of HIV!

- Interestingly, doctors already found out how they managed to make what for many years was considered as impossible?

- There are several versions. One of explanations of this history is connected with a genotype of the donor from which to the patient replaced marrow. In the world there is about 1% of people who under no circumstances cannot be infected with HIV or ache with AIDS. The immunodeficiency virus just does not work well to be fixed and to begin to breed in an organism as such people other structure of the cells, is not present specific receptors by which it is accompanied a virus. Incidentally it turned out so that Berlin to the patient replaced marrow from such donor. Of course, at the time of operation nobody knew about it, details became clear later. Now this person leads normal full-fledged life. Periodically the person passes inspection in the Berlin clinic, but at it do not show any signs of existence of HIV - an infection, both behind health, and in analyses. And it gives hope for a HIV curability in the long term.

- You will not call a bone marrow transplantation an easy, simple and available method of treatment of HIV. Among the novelties sounded at conference there was that closer to a body ?

- It was declared that the third stage of clinical trials on use of a special therapeutic vaccine ended. Probably, you know that vaccines happen two types. Preventive give to healthy people that they did not get sick. Unfortunately, in this direction concerning HIV there is no big progress. And terapevnichn are vaccines which help to overcome pathology when the person is already infected. And so, researchers created a preparation which improves immunity due to stimulation of additional protective factors in an organism. The vaccine transfers a condition of the patient when it is necessary to begin anti-retrovirus therapy. The person all the same passes to ARVT, but progressing term noticeably increases. For example, on average AIDS develops in 5 - 7 years from the infection moment. And the new vaccine will be able to delay AIDS stage to 10 - 12, even till 15 years. This essential extension of life without administration of drugs. Efficiency and safety of a vaccine already checked on animal, healthy volunteers and on groups of the elected sick people. Now a preparation it is necessary to pass a final stage of clinical trials - at the level of population.

Taking medicine, HIV - the positive person is not infectious

- When there is a need for this therapy? How the doctor or the patient learn that it is already time to take a pill?

- There are two approaches to purpose of ARV - therapy. The first - according to clinical indications. If the person has symptoms of an opportunistic infection (experts know this list), then the doctor can appoint therapy, without conducting additional researches. The second approach, more correct and effective, - by results of analyses. Compliance with the national standard of treatment, each HIV - the positive patient once a quarter has to pass special research which is called definition of SD4 of lymphocytes. If their quantity is less than 350 cages on blood microlitre, then it is a signal to start treatment. Earlier this indicator made 200 cages, and now rose to 350. Both of these methods are resolved and are applied in Ukraine.

- If the person in such situation honestly takes the recommended medicine, the person can live long life, without passing to AIDS stage?

- Multicomponent ARVT is used in the world of only 15 years. We have no long supervision therefore today nobody can precisely answer this question. Mathematical models which specify that life expectancy of such person significantly does not differ from average indicators are created. The most important postulate which was sounded repeatedly for the last year while the patient takes medicine and therapy remains effective (that is in blood the virus does not circulate), the person is noncontagious. Numerous researches show that HIV - an infection is not transmitted from the person who accepts ARV - therapy, to the healthy personality. For example, in 2010 research which was conducted in Africa among couples the man - the woman was finished. In each couple one person there was HIV - positive, the second - HIV - negative. Infected used drugs, and from all massif registered only 1 case of infection. But, most likely, transfer of a virus happened still before the partner began to accept this treatment. Other example of efficiency of treatment concerns the program of prevention of transfer of HIV from mother to the child. When HIV - to positive women for pregnancy gave schemes of preparations, the child was not infected, the risk decreased to zero. In Western Europe the share of transfer of HIV of babies makes 0%. In Ukraine this indicator is more - about 6%. It is connected with the fact that at us not all pregnant women are captured by preventive programs. In total experts in the field of HIV - AIDS agree that timely and effective ARV - therapy is a prophylactic at the level of a community, thanks to treatment the virus does not circulate in population. Therefore most of scientists in the world prove: it is necessary to capture treatment not less than 80% of HIV - positive people, and then it is possible to count on recession of epidemic, on reduction of quantity of new cases of infection.

The REFERENCE

of HIV - a human immunodeficiency virus. It causes a disease - HIV - an infection which last stage is known as AIDS - acquired immunodeficiency syndrome.

The FACTS About HIV - AIDS

1. Immunodeficiency viruses very small, are about 60 times less erythrocytes. From 70 to 100 thousand virus particles of HIV can be located on the line 1 centimeter long.

2. The HIV activator - infections is the virus having a spiralka appearance in a triangular core.

3. Getting to a human body, HIV gets into CD4 lymphocytes, macrophages and some other types of cages, begins to breed actively in them. It leads to destruction and death of the infected cages. Viruses leave dead cages, get to new, and the cycle is repeated. Gradually the number CD4 of lymphocytes decreases so that the organism cannot resist to causative agents of opportunistic infections any more - diseases which do not constitute big danger to healthy people with normal immune system.

4. The human immunodeficiency virus is carried to family of retroviruses, a sort of lentivirus (comes from the Latin word lente - slow).

5. The main reason for death of cages of an organism at HIV - an infection is the programmable cellular death (apoptosis). Even at AIDS stage the level of contamination T4 of cages makes 1:1000 that says that the virus in itself is not capable to kill such quantity of cages which actually perishes at HIV - an infection.

6. HIV - it is extremely changeable a virus, its ability to mutate in one million times more, than at a flu virus. In the course of self-reproduction of a virus so often there are genetic changes, practically each virus at least on one nucleotide differs from the predecessor. In the nature of HIV exists in the form of a set quasi - types which can be grouped in several versions. For today HIV - 1 are known, to HIV - 2, for HIV - 3, HIV - 4. All of them considerably differed from each other on several signs, in particular, on different in structure of a genome.

7. After long use of the same scheme of therapy, in several years the virus mutates, gaining resistance to preparations. To further control over progressing of HIV - the infection needs to apply new schemes of treatment with other preparations. Therefore any scheme of treatment of HIV existing for today - infections becomes inefficient sooner or later.

8. HIV is unstable - when drying blood, sperm, a lymph, the liquids which got from an organism to external environment, he perishes. Therefore infection does not occur in the household way.