Given the new data about the slower than expected decay of viral activity in the second compartment, Dr. Ho plans to keep these patients on combination therapy for at least two to two and a half years more before offering them the option of experimentally stopping therapy to see in practice if the HIV has been eradicated. Before that, he plans to look closely at their spinal fluid to see if there is any evidence of remaining viral activity in brain cells. Dr. Ho also presented data on eight patients started on similar treatment after having been infected for several years, though none had received prior antiviral therapy. The results were just about as striking in terms of elimination of evidence of actively replicating virus to be found in the bloodstream. Reductions in other lymph tissues were also striking, but less complete than in the recently infected people.
Many questions remain to be answered.
Nevertheless, there is good news for all of us in Dr. Ho's work on this problem, even if it proves to advance no farther. Other studies supported his finding that reduction of viral load to undetectable levels in the bloodstream correlates with vast reductions of HIV in the lymph nodes and other lymph tissues. This was an open question until recently, and provides encouragement as to the probable durability of good responses to protease combinations. The reduction of infectiousness of the semen after effective antiviral treatment is also good news, even if it does not mean we can skip the condoms from now on. The data on rate of decay of viral activity and replacement of infected cells in the various compartments is new for everyone, and should help guide research in immune system restoration.