work well to eliminate the virus and the immune system doesn’t realize that the cell is infected.
One of the strategies to cure the infection is to basically stimulate these latently infected cells, forcing them to wake up and make virus. When that is done, there are strong combinations of HIV drugs around to get into the cell and prevent the virus from spreading, but there are also drugs to boost the ability of the immune system to kill these latently infected cells, that are now “awake”.
Eventually, all these latently infected cells would be eliminated and there would be no source of virus in a patient suppressed on therapy.
So this case involves a 35-year old Caucasian Brazilian man who came into care and was treated with the standard treatment that most people were receiving at that time for HIV (Efavirenz, tenofovir and 3TC combined into a single tablet, similar to Atripla in the US). Everything went fine with the treatment; the patient tolerated the medicines with no side effects and he was soon totally suppressed (undetectable).
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So now, after two years being undetectable, additional medicines were added. The HIV treatment was intensified by adding two additional powerful drugs, dolutegravir and maraviroc (recall that he was already undetectable). Then another treatment was added called nicotinamide.
Nicotinamide is a form of the vitamin niacin (vitamin B3). So why all these extras? In addition to providing more powerful treatment against HIV, both the nicotinamide and the maraviroc are believed to stimulate these latently infected cells we mentioned earlier, forcing them to
