How is it they can get ‘viral loads’ down to near undetectable levels but not outright kill off the virus?
In: Biology
HIV is a retro virus. Essentially, this means that it infects cells and becomes part of the cells DNA. Specifically, it infects cells that are part of the immune system.
You can treat HIV using antiretroviral drugs. These drugs stop the virus from duplicating in the body and infecting new cells.
The biggest issue with retroviruses is that they are pretty much permanently present in the body. Antiretroviral drugs stop the virus functioning, but as soon as you stop treatment, the infected cells start to produce more copies of the virus.
If you wanted to cure someone of HIV, you would need to remove all of the cells that have HIV in their DNA sequence. Naturally, this is near impossible to do at present, mostly because we cannot identify the specific cells or target them in such a way that healthy cells aren’t also targeted.
HIV hides in your immune system, and there’s currently just no known way of reaching it there. It’s like a safe haven behind our guns where some can always survive and keep making more. We can, however, keep killing the ones that leave that safe haven. We can keep those beaten back effectively enough that there’s never enough to harm you or spread to someone else…. but there’ll always be some hiding away where we can’t get them.
Because the HIV virus does this fun thing where after it infects one of your immune system cells, it can stay in that cell for days or weeks before “activating” and making that cell make and release more copies of the virus.
And those immune systems cells are spread throughout your entire body, some constantly floating around in your blood.
Meaning it’s virtually impossible to full eradicate it because to do so you would have to kill every single one of those cells to guarantee there aren’t any hidden infections still in the body.
Which, is next to impossible.
So instead we have to play this constant game of Whack-a-mole, where anytime one of those secretly infected cells goes bad and decides to pop and release more viruses, the body is able to quickly kill most of those released viruses.
This is what keeping your vital load down means, constantly whacking these virus filled balloons that randomly pop to keep the HIV from completely over running your immune system.
TL:DR: HIV can hide in your cells for weeks, meaning you could think that you are HIV free, and then two days later one of these cells pops and releases a fresh swarm of viruses.
HIV is a retovirus, which means that it makes itself part of the DNA of the cells it infects and gets the cells to make more virus.
The drugs stop the virus getting into the bloodstream and infecting other cells but the DNA is just sitting there hiding in already infected cells, ready to go again if they get the chance.
HIV is a retrovirus which incorporates its DNA into your cellular nuclear DNA. There is currently no approved method to excise ONLY the viral DNA from the chromosome so it highjacks your cellular reproduction methods to make more of itself. We cannot remove the genetic material, but we can slow/stop the cells from making more viruses. This concept applies to any virus with the enzyme Reverse Transciptase, including HSV.
HIV is unique in that it attacks your various immune cells, and also hides out in them in dormancy for long periods of time without adversely affecting the cell.
Our treatments effectively prevent the infected cells from releasing new viral particles outside of the cell, or basically cripple the viral particles that leaves cells so they can’t easily infect new ones, but can’t really get inside already infected cells that make up the viral reservoir to truly eliminate them.
This is somewhat the case for a lot of persistent viral infections. Its why with viral infections you moreso see a big push for vaccinations to let your immune system do the work rather than trying to cure it after its become established. But of course even a vaccination is tricky for HIV.
I know this is about HIV but if you want to expand your knowledge on viruses, read up on the herpes family of viruses. Two of them carry a stigma for people who have them (HSV-1 and HSV-2); however, almost everyone has herpes viruses in them. Chickenpox and CMV virus are the most common. They all have the ability to hide from the immune system and stay in people for life. However, and someone correct me if I’m wrong, they are NOT retro-viruses. They hide in nerve bundles the immune system won’t attack.
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