November #129 : Belly Flop - by Rebecca Minnich

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Table of Contents

Practicing What She Preaches

Keeping the Faith

Missionary Man

Raging Bull

Belly Flop

Dances With Dog

Stop, Go, But Proceed With Caution

Sneak Peek

Bar Exam

Thanks in Advance

Word Up!

What Gives

Team Spirit

Deal or No Deal?

Electile Dysfunction

Take as Directed

Silver Screening

Race for a Cure?

Rio Bravo

Time of the Month

That Masked Man

Reins of Terror

I’m Outta Here

Editor’s Letter-November 2006

Mailbox-November 2007

Catch of the Month-November 2007

Most Popular Lessons

The HIV Life Cycle


Herpes Simplex Virus

Syphilis & Neurosyphilis

Treatments for Opportunistic Infections (OIs)

What is AIDS & HIV?

Hepatitis & HIV

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November 2006

Belly Flop

by Rebecca Minnich

Does gastrointestinal HIV squash treatment?

The headline was hard to stomach: hiv hides in the gut. A University of California at Davis study confirmed that while meds may render the HIV in your bloodstream undetectable, your gastrointestinal (GI) tract lining may still teem with HIV. Because the lining, rich in CD4 cells, houses 70% of your immune system, study leader Satya Dandekar, PhD, suggests starting HIV meds immediately after infection to slow gut-tissue CD4-cell losses. Others wonder whether that’s effective—or necessary.

Dandekar compared the small intestines of ten people who’d gone medless for one to three years after contracting HIV with those of three who’d started meds within four to six weeks of infection. Early treaters, Dandekar says, “had less gut virus and inflammation and more surviving CD4 cells.” She also suggests testing gut-tissue viral load with biopsies (done by inserting a tube through the mouth or rectum) in addition to regular HIV labs.

But Marty Markowitz, MD, who does similar research (but on the large intestine) at New York City’s Aaron Diamond AIDS Research Center, says, “Hitting gut HIV early isn’t applicable,” because even people in his study who’d started meds 14 days after infection had already lost the CD4s. But this caused no symptoms, he says: “no link [with] opportunistic infections, poor treatment outcomes or overall health, nor, most significantly, with increased GI disease.” Dandekar says future HIV meds may hit this HIV reservoir; Markowitz says we won’t know until clinical trials start doing biopsies. Until then, we’ll have to go with our gut.     

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