Despite Misleading Headlines, HIV Can Still Lead to AIDS
To be clear, HIV is still the virus that causes AIDS.
Research published late last month in the journal Cell about how HIV depletes CD4 T cells attracted a lot of attention -- and unfortunately, some inaccurate headlines.
“The popular press had a lot of headlines that unfortunately were not necessarily accurate,” said Dr. Amesh Adalja, a spokesman for the Infectious Diseases Society of America.
The Cell paper, titled, “Cell-to-Cell Transmission of HIV-1 is required to Trigger Pyroptic Death of Lymphoid Tissue-Derived CD4 T Cells,” explained how cells die by “committing suicide” after detecting the presence of HIV.
Previous research has shown that less than five percent of cells die as a result of “productive viral infection,” meaning the virus gets inside, the cell detects it and commits suicide, and then releases particles into the bloodstream known as virions, which go after other cells and begin the process again.
But this paper showed that the infection usually occurs cell to cell, not by the particles of previously killed cells.
”We’ve always known that symptoms and problems with HIV are an interaction between the depleted CD4 cells, creating immune inactivation,” Adalja explained. ”It ends up destroying the immune system over a long period of time to the point where an opportunistic infection can take hold and kill someone.”
But the previous school of thought was that the virion particles are primarily how the virus gets spread around inside the body. The new research shows that is not the case.
“Particles do not directly cause AIDS and the immune cell response; it’s the effect of infected immune cells on other immune cells,” Adalja said. “What they’re finding is that with HIV It’s not the free-floating virus (that causes infection), it’s the cell-to-cell spread. It’s not the HIV virus floating around in the blood.”
Reporting of this research by some mainstream news media resulted in headlines such as “HIV does not cause AIDS,” which fueled dangerous denialist theories.
“HIV is the common factor; HIV is necessary for the whole process to start,” Adalja said. “I really think it’s unfortunate the way it’s being reported by the general press.”
In fact, the new research may spur new HIV treatments. This latest research builds on work by scientists such as Warner Greene of the Gladstone Institute at the University of California-San Francisco. In an interview last year with Healthline News, Greene gave a thoughtful explanation of “pyroptosis,” or cell death by a fiery explosion.
“The infection is aborted, the cell senses it and dies in a fiery inflammation, which sends out a signal to bring new cells into the zone of inflammation, and they also fall prey to the same abortive death,” Greene told Healthline. “It's a vicious cycle.”
Green told Healthline at that time that researchers already have identified the sensor that alerts the cell to self-destruct. He said a drug to turn off the sensor, called IF116, already has been tested in clinical trials and proven safe for humans.
Adalja said this new research could indeed help identify new ways to treat HIV. “Conceptually, it may change the way that people approach newer or novel therapies. For instance, you might be trying to find ways to block cell to cell transmission. Could you find some way to block those cells from committing suicide?”