NRI doctor discovered that the HIV first attacks and destroys the immune cells


Dr Saurabh Mehandru

NEW YORK, September 21 2004
Journal of 'Experimental Medicine

NRI, Dr Saurabh Mehandru and his team of researchers at the Rockefeller University here have discovered that the HIV first attacks and destroys the immune cells or the T-cells in the intestines instead of coursing through the blood cells, as is currently believed to be the case.

The study by Dr Saurabh Mehandru and his team was published this week in the Journal of 'Experimental Medicine', one of the leading scientific journals in the world.

Mehandru, 32, recounted his days in Cambridge School in New Delhi, his being named ``Best Post-Graduate of the Year'' at Medical School in New Delhi, and later being recognised as ``Resident of the Year'' in Internal Medicine at New York University. He said that the discovery also makes it possible to detect the HIV virus within days of the infection.

``It is now possible for HIV to be discovered within 15-20 days of the infection,'' said Mehandru, who spent a year of research on the subject at the Rockefeller University. He adds however that the infected person has no apparent signs of the malaise in his body, and doctors can detect the infection in the intestines only with a biopsy. A healthy person would not go for such a test, he added.

Mehandru's findings reveal that much before changes become evident in the blood, major immune destruction has already occurred in the intestines. He also discovered that while current treatment methods effectively reverse the changes in the blood, they are only partially effective in the intestines.

Based on the research, Mehandru says, it is evident that the intestines play a major role in the development and spread of HIV. ``Current blood tests may be poor indicators of progression of this disease elsewhere in the body. This research opens up a wide and yet unexplored field for developing diagnostic tests, drugs and vaccines that could target the intestines specifically to prevent or control HIV infection,'' he said. Even after extensive research, some of the earliest changes in the human body soon after HIV virus enters it, remain a mystery. For example, it is poorly understood as to how the virus spreads; which cell types are affected first and which are the earliest sites of HIV proliferation in the body.

Mehandru's findings lead the drug manufacturers to tailor specific medicines which could potentially prevent infection or reduce severity of infection.

According to the 2004 United Nations AIDS report released recently, five million people were infected in 2003, the greatest number in one year since the start of HIV/AIDS. The total number of people living with HIV throughout the world reached 38 million in 2003. In the same year three million lives were lost to HIV infection and 20 million have died of HIV and related causes in past 20 years. India now has the second largest number of HIV-infected patients in the world, with 5.1 million diagnosed cases, next only to South Africa.

For the research, Mehandru and his team studied 29 people, of which 13 were newly infected with HIV (within a few weeks), 8 were in various chronic stages of the infection, and 8 were not infected.

``I discovered the difference almost immediately in the first patient when we started out in July, 2003,'' said Mehandru. ``The difference in the destruction of the immune cells in the intestines and the blood cells was remarkable.''

In the next stage of research, Mehandru suggests understanding what makes the intestines uniquely susceptible to the HIV attack.