3D imaging show HIV infection might establish within hours

A fascinating lecture that generated a lot of discussion at R4P2018 showed how advances in modern scanning technologies including PET scans and light sheet microscopy can be used to get more accurate information about the first stages of HIV infection and on the ways that HIV drugs are absorbed and distributed in the body.

Although this talk used animal studies, the approach is safe enough to use in humans. These might have a role in cure research, for example, to look to measure sites of active HIV replication, before or after a treatment interruption as well as in the development of new drugs.

Many of the videos, which are fascinating to watch, were shown as 3D models – rotated to view the distributions from any angle – and then guiding accurate biopsies.

The results looked at HIV transmission in used fluorescent stained proteins to track viral particles in explant tissue or in live animals. One unexpected finding was that virus was transported to mesenteric lymph tissue within hours of infection – indicating that infection can take place much sooner than the 24-48 hours generally assumed. This could have an immediate practical use when modelling PrEP studies.

A second approach, to image drug distribution, can map local absorption of PrEP, for example from a tenofovir vaginal ring, or other topical or system prevention drugs.

As next steps, human imaging that has been discussed for several years is just starting to happen, including in HIV cure research where it has the potential to identify actively productive residual cells.