Study pinpoints where to direct HIV treatment to be effective

Courtney Fletcher

A potential road to curing the HIV-1 infection is highlighted in a recent study co-authored by a University of Nebraska Medical Center researcher.

A team of researchers — including Dr. Courtney Fletcher, dean of the UNMC College of Pharmacy — studied why the HIV virus is never entirely eliminated in patients with the disease even after powerful antiretroviral drugs.

Fletcher and his colleagues found that a substantially lower amount of the drugs makes it to the lymph node and lymphoid tissues. This means replication of the virus persists in these areas of the body.

Fletcher said this problem may be solved by enhanced drug delivery.

"We don't know whether we can really cure HIV infection, but we believe that this road to a cure is going to require that we shut down viral replication throughout the body," Fletcher said. "This work shows a compartment where we haven't done that."

Fletcher said the progress HIV treatment has made over the last couple of decades has been remarkable, but the disease has yet to be eradicated. He said Nebraska is in a good position to contribute to research for a cure because UNMC is a leading expert on drug formulation and delivery.

Fletcher said this project has taken and will continue to need international collaboration.

Fletcher's team includes researchers at the University of Minnesota, Northwestern University, University of Oxford in England and the University of Edinburgh in Scotland. Investigators from the Fred Hutchinson Cancer Research Center in Seattle, the University of Porto in Portugal, the University of California, San Diego, Korea National Institutes of Health and King's College London also contributed.

The team's work was published this week in Nature, a science journal.

Fletcher has applied for a grant with the National Institutes of Health that would allow the team to move forward. The next step, he said, will be finding a way to deliver drugs to the places where HIV continues to replicate.

"We now have a very specific site that we need to target," Fletcher said. "It simply points us in an exact direction that we need to go."

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