Hi
According to a recent report (see below), PET scan can track the
progression of HIV and options of using surgery or radiotherapy can be
integrated to treatment strategy. What's your thought on this
strategy? Thanks.
Positron emission tomography (PET) scans can track the progression of
HIV and could lead to new treatment options and the development of the
next generation of AIDS drugs, according to two recent studies. PET
scans, usually used to identify cancerous tumors, could help fight
AIDS by identifying the virus' impact on lymph nodes, which could be
treated with radiotherapy or surgery.
Dr. C. David Pauza and colleagues at the University of Maryland
Biotechnology Institute in Baltimore took whole-body PET scans of 15
HIV patients and found fairly distinct sites of immune response during
different stages of the disease. "We believe that if we identify those
sites clearly during HIV infection we encourage people to consider
these types of interventions," Pauza said in an interview, referring
to surgery or radiotherapy.
The scans showed that during early HIV, lymph nodes in the head and
neck were activated, but in later stages the virus stimulated an
immune response in areas of the torso and later in the bowel. Surgery
or radiotherapy would open up a new approach to treating HIV/AIDS. "We
are not aware that it has ever been tried," said Pauza. "We think it
is appropriate to consider these approaches and also to learn from the
cancer models because cancer is a disease of chronic cell activation
and growth and in some ways, even though HIV is triggered by a virus,
it has some similarities," he added. The report, "Whole Body Positron
Emission Tomography in Patients with HIV-1 Infection," appeared in the
Lancet (2003;362(9388):959-961).
David Schwartz and Sujatha Iyengar, of the Johns Hopkins University
Bloomberg School of Hygiene and Public Health, also used PET scans to
track HIV progression. They said lymph node removal could give
patients an opportunity for a break in antiretroviral treatment in
their study, "Anatomical Loci of HIV-Associated Immune Activation and
Association with Viremia," also published in the Lancet
(2003;362;(9388):945- 950). "Although many systemic sites from which
latent virus could be re-activated would be left, re-activation might
not occur for months or years after removal of the active nodes,
thereby allowing extended interruption of treatment," the scientists
noted.
Pauza suggested that with the pattern of progression detected with PET
scans, it might be possible to develop a prognostic tool for HIV and
new drugs for patients in whom existing therapies have failed.
"One thing we discovered as we were going through this work is that
there was a substantial amount of undiagnosed cancer associated with
HIV. We observed a number of patients with lymphoma," he said.
