The Jakarta Post
Thirty years ago when people got infected with HIV/AIDS, it was like being hit with a death sentence 'going through the incredible pain of this vicious condition with no cure available
'At that time, I treated so many patients with HIV, mostly young gay men in Australia, and I saw them suffering tremendously with HIV-related infections affecting their brains and immune systems with loads of pain, emotion, stigma and discrimination thrown in,' remembered Sharon Ruth Lewin.
'These kinds of situations motivated me to conduct medical research to find ways to ease their pain.'
Thanks to dedicated scientists around the world, the search for a cure for HIV has made great strides since the discovery of the virus in the early 1980s and today treatment is so efficacious that many people with the virus can live a virtually normal life.
Lewin is among one of the foremost groups of these scientists and an active member of the International AIDS Society (IAS), a group currently developing a global scientific strategy for HIV research to end the epidemic that has already claimed 30 million lives worldwide.
In January 2013, as a professor of medicine at Monash University and director of the infectious diseases unit at the Alfred Hospital in Melbourne, Australia, she led a team from the hospital to uncover HIV's genetic hiding place and found a drug able to seek it out so that the deadly virus could be destroyed.
The research also involved teams from the Burnet Institute, the Peter MacCallum Cancer Center and Australia's National Association of people living with HIV/AIDS.
'Traditional antiretroviral [ARV] medications have been able to stop the virus infecting cells, giving patients a greater life expectancy,' the professor said on the sidelines of the recent International AIDS Asia Pacific (ICAAP) XI in Bangkok.
'But, the virus remained hiding in their deoxyribonucleic acid (DNA), unable to be found and treated so that patients would still have to undergo expensive lifelong ART,' she explained
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, added the professor.
By using the cancer drug, Vorinostat, for two weeks, Lewin had been able to rouse sleeping HIV-infected cells so they could be detected.
The team of researchers was able to bring the virus to notice in 18 HIV patients in a trial that concluded in January 2013.
'It was a kind of shock-and-kill the virus,' she said.
The professor was hoping a new generation of drugs able to kick-start the immune system might now be able to kill the virus. There are more possibilities of getting rid of it by making it visible to drugs and visible to the immune system.
'The research will take a long time before we can make a final conclusion,' she said
'But, I feel so optimistic and energized. There has been so much progress in HIV/AIDS cure research since I became involved in the global research effort in the very early days of the epidemic,' she said, adding that most scientists had seen some light and hope of ending the epidemic.
The success of ARV therapy has led many people now to ask whether the world can stop AIDS. ARV drugs and antiretroviral treatments (ART) are now available and affordable around the world, particularly in low- and middle-income countries.
'The treatment has become quite simple. In the past, patients with HIV had to consume 20 pills a day. Now, any patient with HIV will only have to consume one pill per day,' explained Lewin.
Huge reductions have been seen in rates of death and suffering when use is made of a potent ARV regimen, particularly in the early stages of the disease. Widening access to antiretroviral treatments can also reduce HIV transmissions.
'HIV/AIDS has now turned into a manageable disease. It is no longer seen as a primary death threat. Patients with HIV, especially in their early stages, now have the chance to get wide access to ARV treatments with almost 96 percent life expectancy and will feel less pain.'
Aside from ART treatments, scientists have also conducted a great deal of groundbreaking research. Several of the milestones in research affected Timothy Brown, also known as the 'Berlin patient', who was cured of HIV after a bone marrow transplant from a donor with genetic resistance to HIV infection.
The two 'Boston patients' ' nicknamed for the city where they were treated ' also received bone-marrow transplants with cells that were not resistant to HIV. Both of them seemed to be free of the virus for months after stopping treatment. In late December, researchers reported that the virus had recurred in both of the Boston patients.
Bone marrow transplants and gene therapy to cure HIV might be too complicated and too expensive, she said.
'Any research into a HIV cure has always been important, despite the results. This will lead to further research and clinical trials. Finding HIV/AIDS cures and best treatments have always been time and energy consuming,' she said.
Scientists, she said, needed to inform the public in an honest and measured way what they were working at and the challenges they were facing.
'I am so passionate and excited that we've reached this stage in the research into a HIV cure. But, the search for an HIV cure has still a long way to go and will require innovation, sustainable funding and political commitments from all parties.
Lewin's other important step is to become co-chair of the International AIDS Conference in Melbourne next July.
The international chair of the conference will be Nobel laureate Professor FranÃ§oise BarrÃ©-Sinoussi, AIDS 2014 International Chair, President of IAS and Director of the Regulation of Retroviral Infections Unit at the Institut Pasteur in Paris.
The Melbourne conference's theme will be 'Stepping up the Pace'. The theme reflects the significant progress being made in the scientific world toward HIV/AIDS prevention, cure and treatment and the optimism about the falling rates of new HIV infections worldwide.
'But that is not enough. We have to accelerate the pace to achieve zero AIDS,' said Lewin.
Stepping up the pace reminds us that, despite the significant scientific gains being reported in many countries, success has not translated into an effective response in many others including notably in many parts of the Asia Pacific region
'AIDS 2014 is a significant opportunity to mobilize stakeholders and build on the present momentum necessary to change the course of the epidemic for everyone affected,' she said.
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