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Jakarta Post

World awaits effective and affordable HIV/AIDS cure

  • The Jakarta Post

    The Jakarta Post

Wed, October 8 2014 | 12:36 pm

Prestigious recognition: Health Minister Nafsiah Mboi ( center ) poses with members of the Indonesian civil society group, Persaudaraan Korban Napza Indonesia ( PKNI ) or the Brotherhood for Indonesian Drug Users. The group won a prestigious Red Ribbon Award. JP/Rita A. Widiadana

Out of hundreds of sessions held during the 20th International AIDS Conference, a scientific session '€” Toward HIV Cure '€” stole the attention of all participants and the world, who watched eagerly for news on effective and affordable cures for HIV/AIDS.

'€œWe have plenty of data telling us we can make and we have made progress,'€ Françoise Barré-Sinnoussi, president of the International AIDS Society ( IAS ) and professor at the Institut Pasteur in Paris, told international journalists.

Winner of the Nobel Prize as a co-discoverer of the HIV virus, Barré-Sinnoussi has been one of the driving forces behind global scientists'€™ attempts to find a cure for HIV/AIDS.

'€œWe will need to collaborate and combine different approaches to HIV '€” work on cures as well as therapies, prevention and vaccines '€” and strengthen the relationships between researchers to continue to make progress in tackling HIV.'€ Barré-Sinoussi said. '€œIt is now my duty to get researchers from around the world working together to find better ways to treat and prevent HIV.'€

In the 32 years since scientists discovered HIV, world researchers have gained greater understanding of the its underlying causes, preventions and treatment methods.

Since the US Centers for Disease Control and Prevention published a shocking report in 1981 describing a rare and horrific illness that caused severe fever, fatigue and weight loss, mostly affecting gay men and killing many of them, scientists have been working toward finding a cure.

The search for a HIV cure began when the US Food and Drug Administration ( FDA ) approved the first treatment option, known as Zidovudine or AZT.

When antiretroviral treatment ( ART ) was unveiled at the 1996 International AIDS Conference in Vancouver, Canada, AIDS was transformed into a treatable and manageable disease.

'€œBut ART remained expensive. While AIDS became a manageable disease in Western countries, it was still viewed as a death sentence in most developing countries,'€explained Sharon Lewin, professor of medicine at Monash University in Melbourne and co-chair of AIDS 2014 Conference.

The cost of HIV/AIDS treatments is too much for patients in developing countries, averaging at US$25,000 per year per person.

ART options for HIV patients were further expanded with the FDA'€™s approval of fusion inhibitors in March 2003 and entry inhibitors in August 2007. Between 2009 and 2010, many ART drug therapies were approved in generic form, making them more affordable and thus more acceptable to HIV/AIDS patients worldwide.

In developing countries with mid to high HIV/AIDS incidence, ART remained unattainable, even when costs had dropped to about $10,000 per patient per year in 2000 and to less than $100 by 2010. But the treatment has become simple. '€œIn the past, patients with HIV had to consume 20 pills a day. Now patients only have to consume one pill per day,'€ added Lewin.

In 2012, IAS launched its global scientific strategy to find a cure for HIV, involving more than 200 of the world'€™s leading AIDS scientists and researchers.

Lewin'€™s research was among the most groundbreaking: '€Traditional antiretroviral [ARV] medications have been able to stop the virus infecting cells, giving patients a greater life expectancy, but the virus remained hiding in their DNA, unable to be found and treated so that patients still had to undergo expensive lifelong ART.'€

By using the cancer drug Vorinostat for two weeks, Lewin and her team were able to rouse the sleeping HIV-infected cells so they could be detected.  '€œIt was a kind of shock-and-kill the virus.'€

Seeking out the killer virus with doses of a highly toxic cancer drug was a huge step in curing the disease once viewed as incurable. One of the most talked-about studies presented during the conference discussed the viability of such a method.

Danish researchers have found a way to activate and expose hidden HIV cells to the immune system '€” a major step toward finding a cure for the virus affecting 38 million people.

Ole Søgaard, a doctor from Aarhus University Hospital in Denmark, said a study of six HIV-positive patients showed that a cancer drug, Romidepsin, could '€˜'€™kick'€™'€™ HIV out of its hiding place and into the bloodstream, where it could theoretically be attacked by the immune system. The finding has been hailed as the single most important advance reported at the AIDS 2014 conference.

Søgaard said while patients'€™ immune systems did not destroy the virus, a new trial involving 20 patients would combine this '€œkick'€ approach with an experimental HIV vaccine ( Vacc-4x ) to see if it could stimulate an immune response strong enough to kill the virus.

Steven Deeks, professor of medicine at the University of California, said the Danish research was likely to have a huge impact on HIV research worldwide.

'€œOle'€™s data is the first clear evidence, at least to me, that we can truly identify the latent reservoir, the hidden virus, and shock it out of its hiding place,'€ he said.

Anthony Fauci, director of the US National Institute of Allergy and Infectious Diseases, told conference-goers that a HIV cure may come down to two possibilities '€” eradicating the virus or driving it so far underground that people don'€™t need therapy, even if the HIV is still lurking somewhere.

Fauci further said that an effective cure for HIV would have to have three characteristics: It would have to be simple and easy to administer, with no need for tertiary care; it would have to be at least as safe as the antiretroviral therapy; and it would have to be scalable and affordable enough to treat millions of HIV patients.

- JP/Rita A.Widiadana

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