UC Davis researchers have identified two compounds that in combination have the potential to eliminate HIV from infected individuals. One of the compounds is already FDA-approved and proven safe for humans. The compounds work by "unmasking" hidden HIV virus particles that evade current antiretroviral drugs and the immune system. This discovery could accelerate clinical trials and provide a new tool to potentially cure HIV/AIDS.

1. HIV hiding
inside the cell
HIV hidden in
the cell, along
with the infected
cell, can be killed
by drugs and
immune system
HIV becomes
visible to
immune system
The shock and kill process enables
the destruction of hidden HIV viruses
Shock
Kill
L
urking beneath
the surface, HIV is
always ready to
wage war. Much
like our stealthiest sub-
marines, the virus has
developed a built-in sur-
vival mechanism, giving it
the power to hide from
current drugs as well as
from our immune system.
When HIV infects an
individual, it harnesses
the immune system ma-
chinery to replicate itself
and create an army of HIV
particles. Current drugs
keep HIV patients alive by
stopping this reproduction
process, but HIV has a
secret weapon: It can go
silent and evade the de-
tection of the tools scien-
tists have developed to
fight the disease.
Researchers at UC Da-
vis recently found a com-
bination of two molecules
that together have the
potential to seek out and
destroy the hidden virus,
completely eliminating
the disease from those
infected. With an estimat-
ed 36.9 million people
worldwide living with HIV
in 2014, the therapeutic
advance promises a global
impact.
“We don’t have any
really good tool to kill the
virus,” said Guochun
Jiang, the first author of
the paper that describes
the work. “This is the
problem and this is a very
important public interest.”
As a bonus, researchers
may have found the tool
in a cancer drug that’s
already been approved by
the U.S. Food and Drug
Administration. Prior
approval means the treat-
ment could bypass years
of regulatory obstacles for
clinical trials, accelerating
its way to patients.
“When any new com-
pounds get discovered or
identified, it takes a really,
really long time for them
to go through patient
clinical trials,” said Satya
Dandekar, lead author of
the paper and professor of
microbiology at UC Davis.
“It takes an enormous
amount of resources and
the major limitation is
really the amount of time
it takes.”
For that reason, she
said, her lab “took a dif-
ferent approach.”
She added that the
group asked themselves,
“What are the molecules
or compounds which al-
ready have great promise
and have already been in
use in patients, so at least
we know they are safe to
use in humans?”
People who are HIV
positive take a regimen of
drugs to combat infection,
defend the immune sys-
tem and provide protec-
tion from drug resistance.
With five different classes
of HIV medication, people
generally take three drugs
from at least two classes.
Patients take more than
one drug because doctors
want to attack the virus at
all possible angles of the
replication process to give
those infected the best
chance at survival. The
ability of HIV to survive
the onslaught of medica-
tion comes down to its
ability to clock itself and
become invisible.
“HIV has the ability to
go into a latent, silent
state in the cells,” Dande-
kar said. “This is a tre-
mendous capacity of the
virus in that it can manip-
ulate, exploit and hijack
the host immune surveil-
BY KATIE L. STRONG
kstrong@sacbee.com
Number of people estimated to be living with HIV in 2014
North America and Western
and Central Europe: 2.4 million
Middle East and
North Africa: 240,000
Sub-Saharan Africa: 25.8 million
Eastern Europe and
Central Asia: 1.5 million
Asia and the Pacific: 5 million
Source: UNAIDS (Joint United Nations Programme
on HIV and AIDS) 2014 fact sheet
Caribbean: 280,000
Latin America: 1.7 million
Margaret Spengler
mspengler@sacbee.com
One-two punch
knocks out HIV?
Source: UNAIDS
In 2014, 2.6 million
children worldwide
were living with
HIV (less than
15 years old)
Courtesy of Satya Dandekar
SEE HIV, 7C
. .............................................................................................................................................................................
UC Davis researchers identify two compounds that team up on virus
. .............................................................................................................................................................................
One compound is already FDA-approved, and proven safe for humans
. .............................................................................................................................................................................
Compounds ‘unmask’ HIV virus particles that hide from current medications
. .............................................................................................................................................................................
TUESDAY SEPTEMBER 1 2015 6CFACEBOOK.COM/SACRAMENTOBEE
TWITTER.COM/SACBEE_NEWSSACBEE.COM
ExploreHEALTH
DEAR KELLY: I want to be pop-
ular. I don’t know how to do it. I
think I’m too shy or too ugly or
too short to be popular. All the
popular kids are pretty or athlet-
ic or dress very well. I don’t
think I am any of those, and I
don’t have all the cool new
things all the popular people
seem to have. Everyone is so
nice to the popular kids at my
school; even the teachers seem
to act differently. I hardly have
any followers on Instagram or
Snapchat and when I do put
something on, no one seems to
notice. It’s so obvious I’m so
average and no one really cares
what I do. Do you have any
advice or suggestions?
– Just Average
DEAR AVERAGE: Being popular
is such a subjective issue. It
depends on the school, the
people there and how you por-
tray yourself. There are no guar-
antees as to how to be popular
because, honestly, it depends
more on the individuals and
how they act or present them-
selves and less on how they look
or what they wear. Instead of
focusing on being popular, focus
on becoming social, involved
and happy with who you are.
Let’s start by addressing how
you view yourself. Seeing your-
self as too ugly or too short is a
self-image problem. Lacking
confidence in yourself reflects
to other people. If you don’t
think that you are the bomb,
they definitely won’t as well.
Confidence is contagious. Peo-
ple pick up on our strengths as
well as our weaknesses. If you
point out all your self-perceived
weaknesses, others will miss out
on getting to know all your
strengths. Think about how you
walk into a classroom. Is your
head held high and are you
making eye contact with people,
or are you looking down and
avoiding people? Confidence is
far more attractive than good
looks. Self-confidence speaks
way louder than any words.
Write down your strengths.
Regardless of what you think,
you have plenty of strengths.
We all do. Find your niche.
Focus on that. If you are great at
math, lean into that gift. Offer
to tutor people. Help others in
class if they are struggling.
Once they see you as smart and
supportive, you have now estab-
lished yourself as someone
others will remember. Perhaps
you play the guitar or are an
artist. Offer to play at a school
event or design the class shirt or
make the posters for a rally.
Switch your mindset from want-
ing to be popular to wanting to
be known for what you do best.
Start putting yourself out
there and joining clubs or activ-
ities at school. The best way to
expand your friend group is to
become an active participant at
school. If you go to school and
leave without interacting with
anyone, no one will know you.
The more clubs or activities you
join, the more people you will
meet. You don’t need to be the
best athlete to join the wrestling
team, cross country team or any
other team. A good attitude and
the willingness to do your best
will make for a positive experi-
ence with sports. Being a part of
the team, even if you aren’t the
starter, will still allow you to
meet new friends and expand
your horizons. If sports aren’t
your thing, there are typically
clubs for every possible interest
at most schools. Think about
what you like to do and go for it.
If there isn’t a club, start one.
Putting yourself out there
means you take an active role in
your life and the self-loathing
gets kicked to the curb.
One fault many people make
is assuming that “stuff” or
things makes people popular.
Not true. For most people, being
well known or having a lot of
friends comes from their per-
sonality. Cars, iPhones or cool
clothes doesn’t make someone
popular. Look within yourself
instead of seeing material
things as the golden ticket to
having more friends. Being
friendly, outgoing, open-minded
and easy to talk to are the qual-
ities people are looking for in a
friend. Sometimes people can
be popular but not admired.
Being feared or hated is not the
same as being popular and
TEEN TALK
What’s
it take
to be
popular?
BY KELLY RICHARDSON
krichardson@sacbee.com
SEE TEEN TALK, 7C

2. TUESDAY SEPTEMBER 1 2015 7C
ExploreSACBEE.COM
Ask Emily is a biweekly
column by Emily Bazar of
the CHCF Center for
Health Reporting, answer-
ing questions about the
Affordable Care Act. Read
her columns at
sacbee.com/ask-emily.
Whether you get your
health insurance from
your employer, Covered
California or the open
market, more of you are
picking – or being forced
into – high-deductible
plans.
Although these plans
come with relatively
cheap premiums, you
must spend thousands of
dollars out of pocket be-
fore your coverage kicks
in.
In theory, you’ll be less
likely to pursue unneces-
sary doctor visits and
treatments if you have a
greater financial stake in
the process, ultimately
helping slow the runaway
rise in health-care costs.
“Increasingly, people
are spending their own
money instead of some-
one else’s money, and
they’re going to start pay-
ing attention,” says James
Robinson, professor of
health economics at UC
Berkeley.
But paying attention to
health-care costs isn’t
easy.
The price tag for the
same medical procedure
can vary from provider to
provider, sometimes by
thousands of dollars. If
you want to be a savvy
consumer who shops
around, “it is very diffi-
cult, if not impossible, for
people to know with any
precision what prices will
be in advance,” says Betsy
Imholz of Consumers
Union.
True, it won’t be easy.
But I’ll provide some tips
to get you started.
Q:Q: I have lower back pain
and my doctor ordered an
MRI. My health insurance
has a $6,500 deductible.
Should I go to the imag-
ing center my doctor
recommended or search
for a better price else-
where?
A:A: A survey by Castlight
Health last year found
that the price of a lower-
back MRI ranges from
$589 to $3,076 in San
Diego, depending on the
provider. In Fresno, it
costs between $636 and
$921.
The potential for sav-
ings is great. But whether
you should shop around
depends on several fac-
tors.
Some health plans lend
themselves to price-shop-
ping more than others.
You may have more flex-
ibility if you have a PPO
(Preferred Provider Or-
ganization) instead of an
HMO (Health Mainte-
nance Organization). I’ll
explain below.
Second, price-shopping
isn’t for medical emergen-
cies. It’s most appropriate
if you need what Jeanne
Pinder calls a “discretion-
ary procedure” that allows
you choice in providers
and time to research.
Pinder is a former New
York Times journalist who
started ClearHealth
Costs.com in 2011 when
she realized that people
were being told to be
active health-care con-
sumers without having the
tools – or reliable price
data – to do so.
She warns consumers
not to assume that high
prices equate to better
quality. “Study after study
has shown that price and
quality are not linked,”
she says.
In California, Clear-
HealthCosts has part-
nered with NPR radio
stations in Los Angeles
and San Francisco to cre-
ate PriceCheck sites
where consumers can
report – and search – costs
for several common pro-
cedures, including mam-
mograms and colonosco-
pies.
Before you start shop-
ping, ask your doctor for
the exact name of your
treatment and the accom-
panying procedure codes.
There may be more than
one, and you’ll need them
all for an accurate esti-
mate.
Once you have that
information, dive in:
A First, read the
Healthcare Financial
Management
Association’s consumer
guide, “Understanding
Healthcare Prices,” avail-
able at www.hfma.org/
consumerguide. It will
help you understand key
terms and concepts that
are critical to making
informed decisions.
A If you have job-based
insurance, your employer
may provide resources,
such as Castlight Health’s
price and quality data.
Check with your human
resources department.
A Consider the provid-
er’s network status, which
may affect how much
insurance coverage you
receive and whether the
amount you pay out of
pocket will be applied to
your deductible. With an
HMO, for instance, “if
you go out of network
without the insurer’s ap-
proval, the procedure
won’t be covered at all,”
says Charles Bacchi, presi-
dent of the California
Association of Health
Plans.
A Call your health plan
or check its website. Many
have cost calculators that
will help you compare
prices at different facil-
ities. “In some cases,
health plans will be specif-
ic about the price of a
service, and other times
they can’t be,” Bacchi
says. “That’s because of
their contractual obliga-
tions to providers who
don’t want price or quality
data to be reported publi-
cly.”
A Sample several online
resources to understand
price range. In addition to
ClearHealthCosts, FAIR
Health has a “Consumer
Cost Lookup” tool at
FairHealthConsumer.org.
This fall, Consumers Un-
ion, working with UC San
Francisco and the state,
will launch another site
highlighting the costs of
some common procedures
by region, Imholz says.
A If you can’t pinpoint
the exact price, look for
the amount that Medicare
reimburses for procedures
in your region, which is
“the closest thing to a
fixed benchmark price in
the marketplace,” Pinder
says. Find them at Clear-
HealthCosts by procedure
code or by searching the
Medicare Physician Fee
Schedule lookup tool at
www.cms.gov.
A Call providers directly
and ask about cash rates.
They may give you a low-
er price if you pay up front
and/or agree not to bill
your insurance. “Don’t be
afraid to ask for a lower
price,” Pinder says. To be
clear, if you pay cash, your
outlay may not be applied
to your deductible.
In all of these cases,
when you’re quoted a
price, make sure you un-
derstand what the figure
means. Is it the full cash
price? Is it the portion you
would pay if your insur-
ance were applied? Is it an
average?
And remember, this
isn’t foolproof. You may
come across conflicting
information in your search
or contend with providers
who won’t tell you the
exact cost of a procedure.
Luckily, it’s getting
better. “The information
out there is incomplete.
There are a lot of flaws,”
Robinson says. “But it’s
improving.”
Questions for Emily:
AskEmily@usc.edu
The CHCF Center for
Health Reporting partners
with news organizations to
cover California health
policy. Located at the USC
Annenberg School for
Communication and
Journalism, it is funded by
the nonpartisan California
HealthCare Foundation.
ASK EMILY
How to
shop for
health
services
By Emily Bazar
CHCF Center for Health
Reporting
Please submit your event
information online. Go to
sacbee.com/calendar and
click on “Add Event.” The
submission deadline for
print is two weeks in
advance of the event date.
Wednesday
Preventing and Reversing
Hypertension
Learn the potential causes of
hypertension and several key
strategies to approach this
condition in a holistic way.
Sacramento Natural Foods
Co-op, 1900 Alhambra Blvd.,
Sacramento. $10-$15. 916-868-
6399. www.sacfoodcoop.com.
6:30-8:30 p.m.
Thursday
Healthy Living with Diabetes:
Your Plan for Success
Learn how to reduce risk of
diabetes complications, stay
motivated, and deal with emo-
tions. Marshall Medical Center,
681 Main St., Placerville. Free.
530-672-7021.
9:30-11:30 a.m.
Saturday
River Run For Youth
The event includes a timed
and untimed 5K run/walk and a
1/4-mile kids race and benefits
the Collings Teen Center. Raley
Field, 400 Ball Park Drive, West
Sacramento. $20-$40. 916-319-
4700.
8 a.m.
WIPEOUTRUN Sacramento
A run based on the hit TV
show “Wipeout.” Cal Expo
Fairgrounds, 1600 Exposition
Blvd., Sacramento. $54-$85.
916-263-3000. wipeoutrun.com.
8 a.m.-5 p.m.
Sunday
Meditation on the Inner Light
& Sound
An introductory talk will be
given by a regional speaker,
with an optional vegetarian
lunch. Sierra 2 Center for the
Arts and Community, 2791 24th
St., Sacramento. Free. 916-492-
2671. knowthyself.org.
Noon-1 p.m.
Sept. 9
Dr. & the Chef
Learn how to eat for sus-
tained energy throughout the
day. Sacramento Natural Foods
Co-op, 1900 Alhambra Blvd.,
Sacramento. $35-$45. 916-455-
2667. www.sacfoodcoop.com.
6-8:30 p.m.
Sept. 10
Alzheimer’s Lecture
The topic is “Alzheimer’s
Behaviors: How Do I Manage
Them? ” MIND Institute, 2825
50th St., Sacramento. Free.
916-734-5728.
6-7 p.m.
HEALTH
CALENDAR
lance and controlling
mechanisms and use it for
its own benefit. While
there is the whole storm
of the viral infection, right
in that storm is the calm-
ness that the virus sits in.
The immune system can-
not detect it. They pose a
major threat and danger.”
The virus cannot cause
harm in these hiding
spots, but it is always
waiting to attack if a per-
son stops undergoing
therapy. Even our most
effective HIV drugs, if
taken for 50 years or
more, can’t reach the
virus in this silent state.
One emerging method
to get rid of the virus is
called “shock and kill,” a
two-part process that
involves “shocking” hid-
den virus particles out of
concealment. While it
causes the unmasked
virus to start replicating, it
also means that HIV is
now detectable, and can
be “killed” by drugs and
the immune system.
An ideal drug therapy
would need to do both
processes, and new re-
search from Dandekar’s
lab recently demonstrated
the power of a compound,
known as PEP005, in a
current cancer drug for
“shocking” the virus.
Molecules like these could
eventually be incorporat-
ed into current therapies
to completely eliminate
the virus from infected
individuals.
PEP005 was able to
revive HIV from its silent
form into an active virus.
It’s contained in a drug
called PICATO, which is
FDA-approved for treat-
ment of actinic keratoses,
or skin lesions that can to
turn into skin cancer. The
compound proved suc-
cessful in test tubes and
cell samples taken from
patients with HIV.
Researchers tested
PEP005 in combination
with other chemicals, and
found that a molecule
known as JQ1 works syn-
ergistically with it. These
two compounds together
increased HIV activation
from its silent state by
15-fold compared with
instances where no drugs
were administered.
These two compounds
will continue to be studied
in the lab, but the process
of getting effective medi-
cation into infected hu-
mans could be expedited
since one of them is al-
ready FDA-approved.
“At the end of the day,
we are really talking about
lots of HIV-infected pa-
tients out there,” Dande-
kar said. “The focus is
really them and HIV era-
dication. HIV has been a
major cost on very pre-
cious human life and the
quality of life.”
This work was pub-
lished online in PLOS
Pathogens on July 30.
Researchers from the
University of California,
San Francisco, the San
Francisco Veterans Affairs
Medical Center and Wil-
liams College collaborated
on this study.
FROM PAGE 6C
HIV
liked. Those people aren’t
known for positive rea-
sons and their status is not
genuine. You should aim
to be respected by people
whose opinion matters –
this is not something that
can be bought or manu-
factured.
Probably the best advice
about being well-known
or accepted is to be the
best you that you can be.
That means stop compari-
ng yourself to others and
start loving who you are.
If being popular means
conforming to someone
you aren’t or compromis-
ing your core values or
principles, then it’s not
worth it. Don’t change
your core self so people
will like you. Be yourself
and the right people will
love the real you.
Being popular is an
enigma. It seems so nat-
ural to those who are a
part of it and so difficult
to those who aren’t. But it
shouldn’t be this way. It
should be about you find-
ing your groove with peo-
ple like you who like you.
Don’t focus on being liked
by everyone, concentrate
on being liked by the right
people who make you feel
happy. Social media don’t
determine your value.
Remind yourself daily of
all that makes you unique
and wonderful. Once you
start to believe in yourself,
the world will believe in
you as well. Let go of
trying to be popular and
work at being you and
showing people all that
makes you great.
FROM PAGE 6C
TEEN TALK
The lure of the wild has
recently attracted an in-
teresting batch of solitude
seekers: Reese Wither-
spoon (“Wild”), Mia Wasi-
kowska (”Tracks”) and
Robert Redford, twice.
Two years after “All Is
Lost,” Redford has
swapped the sea for the
woods, and wordless iso-
lation for Nick Nolte. It’s
not a bad trade.
“A Walk in the Woods”
is a broad and congenial
comedy about two aged
old friends trying to hike
all 2,000-plus miles of the
Appalachian Trail, from
Georgia to Maine. It’s
light on its feet, even
though its geriatric wood-
smen are plodding and
grunting.
The story, taken from
Bill Bryson’s 1998 book,
might seem like the kind
of hokey comedy trotted
out for older moviegoers.
It is that, to be sure. But
Redford and Nolte are a
class, or two, above the
standard stars of such
fare. While “A Walk in the
Woods” is tame stuff,
indeed, a simple, comic
stroll with pleasant com-
pany is a decent way to
end a movie summer
where the usual pace is a
Tom Cruise sprint.
Redford has been trying
to adapt Bryson’s book for
10 years, and he’s now
older than the author was
when he made his trip,
along with his pal Stephen
Katz (Nolte). It makes
their endeavor, particular-
ly with the wheezing
Nolte, a little incredulous.
Nolte’s Katz, a former
alcoholic and proud phi-
landerer, was never an
ideal hiking companion;
he’s the only one Bryson
could get to go with him.
But Nolte, 74 and so croa-
ky he can be hard to un-
derstand, is now more
convincing as a grizzly
bear than a camper. This,
thankfully, is not a movie
where the actors are
weighing down their back-
packs for the sake of real-
ism.
The germ for the trip
begins when Bryson re-
turns to his New Hamp-
shire home after a hum-
bling book tour where he’s
met with questions of
retirement – likely the
same kind Redford has
become accustomed to
fielding but happily (for
our sake) ignoring. Au-
thors, Bryson responds,
don’t retire. They either
drink themselves away or
blow their brains out.
But Bryson is instead
drawn by a mysterious
longing to hike the Appa-
lachian Trail. His con-
cerned wife (Emma
Thompson – now there’s a
couple) insists he find a
companion. When every-
one he can think of turns
him down, Katz, with
whom Bryson had lost
touch, calls him up to say
he’s game.
After the two set out in
Georgia, their adventures
unfold in episodic encoun-
ters and pratfalls. Along
the way, they meet Kris-
ten Schaal (as an annoying
fellow hiker), an attractive
innkeeper (Mary Steen-
burgen) and, inevitably, a
bear.
But whereas “Wild”
sought redemption across
the country on the Pacific
Crest Trail, profundity
isn’t the pursuit of Bryson,
Katz and “A Walk in the
Woods.” Director Ken
Kwapis (“Big Miracle”)
steers it on well-trod but
pleasant buddy-comedy
paths that offers few sur-
prises other than the un-
diminished appeal of its
ambling stars.
MOVIE REVIEW
In ‘Walk,’ two stars
stroll familiar ground
BY JAKE COYLE
The Associated Press
FRANK MASI Broad Green Pictures
Robert Redford, left, as Bill Bryson, and Nick Nolte as
Stephen Katz star in ‘A Walk in the Woods.’
.......................................................
A Walk in the
Woods
EE 1
⁄2
Cast: Robert Redford, Nick
Nolte and Emma
Thompson
Director: Ken Kwapis
104 minutes
Rated R (for language and
some sexual references
......................................................