Prospects brighten for HIV/AIDS treatments

The Thai trial renewed hope in the quest to find a vaccine Copyright: WHO/P.Virot

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A number of recent developments in HIV/AIDS research have led to renewed optimism among the HIV/AIDS research community about the prospects of controlling, and perhaps even curing, the disease.

After more than 20 years of setbacks, the first successful HIV vaccine trial was conducted in Thailand on 16,000 people last year, lowering the infection rate by 30 per cent. "We showed for the first time that it’s possible," said Jerome Kim — deputy director of science at the US Military HIV Research Program and a lead investigator on the trial for the candidate vaccine, known as RV144 — in an article in Nature.

Elsewhere, researchers are searching ‘broadly neutralising antibodies’, which attach to HIV strains and prevent them from infecting cell. An inability to draw these out has so far hampered vaccine efforts.

But progress in doing so in guinea pigs and rabbits has provided some hope, as has inserting the genes for these antibodies into cells via an engineered virus to successfully protect monkeys from an HIV-like virus.

But no-one can predict when a vaccine will be ready. "What you can say is that it would be a major miracle if we had one in less than ten years," Gary Nabel, head of the NIH’s Vaccine Research Center said.

"On the other hand, we’re doing everything we can to surprise ourselves."

Until a vaccine is possible, millions of infected people will rely on drug therapies to control the disease. Since the success of highly active antiretroviral therapy (HAART) in controlling the disease, scientists are once again looking into developing drugs that could fully eradicate the virus in the body — curing, rather than just controlling the disease.

Although several promising drugs are in the pipeline, the problem remains of dormant viruses harboring hard-to-reach cells in the brain, gastrointestinal tract or even stem cells. A cure would have to flush out all of these cells. Last year, leading researchers called for investigation into where the virus is likely to be hiding — an effort that would require collaboration between academia, industry and governments.

"If we’re going to come up with an eradication strategy, it’s not going to be just as simple as purging the virus from T cells," said Mario Stevenson, a researcher at the University of Massachusetts, United States.

But "scientists are stubborn", he said. "That persistence on the part of the scientific community hopefully exceeds the persistent qualities of the virus."

Link to full article on HIV vaccines in Nature

Link to full article on HIV cures in Nature