Tag Archives: HIV Cure

Early HIV drugs ‘functionally cure about one in 10′

Posted on March 15, 2013 by | Comments Off

HIV Medicine

Rapid treatment after HIV infection may be enough to “functionally cure” about a 10th of those diagnosed early, say researchers in France.

They have been analysing 14 people who stopped therapy, but have since shown no signs of the virus resurging.  It follows reports of a baby girl being effectively cured after very early treatment in the US.  However, most people infected with HIV do not find out until the virus has fully infiltrated the body.

The group of patients, known as the Visconti cohort, all started treatment within 10 weeks of being infected. The patients were caught early as they turned up in hospital with other conditions and HIV was found in their blood.

They stuck to a course of antiretroviral drugs for three years, on average, but then stopped.  The drugs keep the virus only in check, they cannot eradicate it from its hiding places inside the immune system.  Normally, when the drugs stop, the virus bounces back.

Control

This has not happened in the Visconti patients. Some have been able to control HIV levels for a decade.

Dr Asier Saez-Cirion, from the Institute Pasteur in Paris, said: “Most individuals who follow the same treatment will not control the infection, but there are a few of them who will.”  He said 5-15% of patients may be functionally cured, meaning they no longer needed drugs, by attacking the virus soon after infection.

“They still have HIV, it is not eradication of HIV, it is a kind of remission of the infection.”

Their latest study, in the journal PLoS Pathogens, analysed what happened to the immune system of the patients.  Early treatment may limit the number of unassailable HIV hideouts that are formed. However, the researchers said it was “unclear” why only some patients were functionally cured.

Dr Andrew Freedman, a reader in infectious diseases at Cardiff University School of Medicine, said the findings were “certainly interesting”.

“The presumption is that they’ve started treatment very early and the virus hasn’t spread to so many of the long-term reservoirs and that’s why it works.  Whether they’ll control it forever, or whether it’ll be for a number of years and subsequently they will progress and the virus will reappear, we don’t know.”

However, he cautioned that many patients would be diagnosed much later than in this study.

Deborah Jack, the chief executive of the National AIDS Trust said it was “exciting times” in progress towards an HIV cure, but the key was early treatment.

“This just underlines the importance of people being testing and diagnosed early. Currently half of people living with HIV in the UK are diagnosed late – indicating that they are likely to have been infected for five years.”

Analysis

There have been two stories about HIV ‘cures’ in two weeks now – yet the latest developments offer little to the majority of people living with HIV.

In the Mississippi baby case and in the Visconti cohort the infection was caught very early, within weeks, at a vulnerable stage.

This suggests that by hitting the virus hard when it first infects the body, it might be possible to live for years without needing treatment – a functional cure.

However, these patients were the lucky few who were detected in the days and weeks after infection. Most cases are detected years later. For these patients a cure looks, at best, distant.

The hope is that by investigating how patients treated early, and a group of people who are genetically resistant to HIV, can combat the virus – it will give scientists clues for developing cures for everyone else.

Original Article by James Gallagher
Health and science reporter, BBC News

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MEDICAL HISTORY – Child Born with HIV Cured!

Posted on March 3, 2013 by | 3 Comments

cure

It’s all over the internet.. click here to see for yourselves…

Doctors in the US have made medical history by effectively curing a child born with HIV, the first time such a case has been documented.

The infant, who is now two and a half, needs no medication for HIV, has a normal life expectancy and is highly unlikely to be infectious to others, doctors believe.

Though medical staff and scientists are unclear why the treatment was effective, the surprise success has raised hopes that the therapy might ultimately help doctors eradicate the virus among newborns.

Doctors did not release the name or sex of the child to protect the patient’s identity, but said the infant was born, and lived, in Mississippi state. Details of the case were unveiled on Sunday at the Conference on Retroviruses and Opportunistic Infections in Atlanta.

Dr Hannah Gay, who cared for the child at the University of Mississippi medical centre, told the Guardian the case amounted to the first “functional cure” of an HIV-infected child. A patient is functionally cured of HIV when standard tests are negative for the virus, but it is likely that a tiny amount remains in their body.

“Now, after at least one year of taking no medicine, this child’s blood remains free of virus even on the most sensitive tests available,” Gay said.

“We expect that this baby has great chances for a long, healthy life. We are certainly hoping that this approach could lead to the same outcome in many other high-risk babies,” she added.

The number of babies born with HIV in developed countries has fallen dramatically with the advent of better drugs and prevention strategies. Typically, women with HIV are given antiretroviral drugs during pregnancy to minimise the amount of virus in their blood. Their newborns go on courses of drugs too, to reduce their risk of infection further. The strategy can stop around 98% of HIV transmission from mother to child.

In the UK and Ireland, around 1,200 children are living with HIV they picked up in the womb, during birth, or while being breastfed. If an infected mother’s placenta is healthy, the virus tends not to cross into the child earlier in pregnancy, but can in labour and delivery.

The problem is far more serious in developing countries. In sub-Saharan Africa, around 387,500 children aged 14 and under were receiving antiretroviral therapy in 2010. Many were born with the infection. Nearly 2 million more children of the same age in the region are in need of the drugs.

In the latest case, the mother was unaware she had HIV until after a standard test came back positive while she was in labour. “She was too near delivery to give even the dose of medicine that we routinely use in labour. So the baby’s risk of infection was significantly higher than we usually see,” said Gay.

Doctors began treating the baby 30 hours after birth. Unusually, they put the child on a course of three antiretroviral drugs, given as liquids through a syringe. The traditional treatment to try to prevent transmission after birth is a course of a single antiretroviral drug. The doctor opted for the more aggressive treatment because the mother had not received any during her pregnancy.

Several days later, blood drawn from the baby before treatment started showed the child was infected, probably shortly before birth. The doctors continued with the drugs and expected the child to take them for life.

However, within a month of starting therapy, the level of HIV in the baby’s blood had fallen so low that routine lab tests failed to detect it.

The mother and baby continued regular clinic visits to the clinic for the next year, but then began to miss appointments, and eventually stopped attending all together. The child had no medication from the age of 18 months, and did not see doctors again until it was nearly two years old.

“We did not see this child at all for a period of about five months,” Gay told the Guardian. “When they did return to care aged 23 months, I fully expected that the baby would have a high viral load.”

When the mother and child arrived back at the clinic, Gay ordered several HIV tests, and expected the virus to have returned to high levels. But she was stunned by the results. “All of the tests came back negative, very much to my surprise,” she said.

The case was so extraordinary, Dr Gay called a colleague, Katherine Luzuriaga, an immunologist at Massachusetts Medical School, who with another scientist, Deborah Persaud at Johns Hopkins Children’s Centre in Baltimore, had far more sensitive blood tests to hand. They checked the baby’s blood and found traces of HIV, but no viruses that were capable of multiplying.

The team believe the child was cured because the treatment was so potent and given swiftly after birth. The drugs stopped the virus from replicating in short-lived, active immune cells, but another effect was crucial. The drugs also blocked the infection of other, long-lived white blood cells, called CD4, which can harbour HIV for years. These CD4 cells behave like hideouts, and can replace HIV that is lost when active immune cells die.

The treatment would not work in older children or adults because the virus will have already infected their CD4 cells.

“Prompt antiviral therapy in newborns that begins within days of exposure may help infants clear the virus and achieve long-term remission without lifelong treatment by preventing such viral hideouts from forming in the first place,” said Dr Persaud. “Our next step is to find out if this is a highly unusual response to very early antiretroviral therapy or something we can actually replicate in other high-risk newborns.”

Children infected with HIV are given antiretroviral drugs with the intent to treat them for life, and Gay warned that anyone who takes the drugs must remain on them.

“It is far too early for anyone to try stopping effective therapy just to see if the virus comes back,” she said.

Until scientists better understand how they cured the child, Gay emphasised that prevention is the most reliable way to stop babies contracting the virus from infected mothers. “Prevention really is the best cure, and we already have proven strategies that can prevent 98% of newborn infections by identifying and treating HIV-positive women,” she said.

Genevieve Edwards, a spokesperson for the Terrence Higgins Trust HIV/Aids charity, said: “This is an interesting case, but I don’t think it has implications for the antenatal screening programme in the UK, because it already takes steps to ensure that 98% to 99% of babies born to HIV-positive mothers are born without HIV.”

Original Article via The Guardian

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Can Blood Transfusions Cure HIV?

Posted on February 28, 2013 by | 3 Comments

Blood-Transfusion-2

In a different take on health and HIV related questions, Gawker reader, Michael, asks the question, “can massive blood transfusions be used to treat HIV”?

THE QUESTION:

Is it possible to cure, or at a minimum delay the effects of, HIV by simultaneously drawing infected blood and transfusing in ‘clean’ blood into the patient? You would still have tainted blood in the system, but wouldn’t this turn the clock back a bit in regard to how much of the virus is in the person’s blood stream?”

Here’s what doctors say on EXTREME blood transfusions as a fix for HIV

Dinesh Rao, assistant professor, David Geffen School of Medicine at UCLA:

Not a bad question actually. The issue is that the virus infects T cells and these reside both in the blood and in tissues, such as the lymph nodes and the gastrointestinal tract. So even if one were to entirely rid the blood of the virus (which would be really difficult to accomplish), there would be other sites such as those I mention that would still have “reservoirs” of virus. Add to this the difficulty and potential complications of doing the blood exchange, which is done for certain other conditions… And you have a sufficiently bad benefit/harm ratio to make the procedure untenable.

Michael Saag, Director, Center for AIDS Research, University of Alabama at Birmingham:

Evidence for most infectious disorders is detected in the blood. This does not mean that the blood is the location of the infection. In the case of HIV, most / all of the virus replication occurs in lymphoid tissue (gut, spleen, lymph nodes), NOT in the bloodstream. Blood is simply a place were we can readily detect it. And while blood can transmit HIV, it is because the virus is present in blood not because it is replicating there. Therefore, removing ‘infected’ blood and replacing it with ‘clean’ is like taking a cup of water from the ocean and then pouring in a cup of fresh water in the hopes you would make the ocean a very large freshwater lake!

Michael Poles, associate professor, NYU School of Medicine:

The short answer is that it wouldn’t work. HIV is a retrovirus and, as such, integrates it’s reverse transcribed DNA into the host cell genome. That DNA will sit dormant in a lymphocyte until the cell dies. as such, there will be plenty of cells that contain HIV DNA sitting around, not just in the blood stream, but in the tissues, most notably the intestines. Even if you could replace all of the peripheral blood through transfusion, additional lymphocytes would be in the tissues and would continue to produce virus, which would just infect the cells that you have transfused in.

Patrick Fogarty, assistant professor of medicine, University of Pennsylvania:

I can think of a few reasons why the approach you mentioned would not work, including that HIV infection is not a process that is confined to the intravascular space (meaning inside the blood vessels). The tissue through which the infection gained access to the body (needle stick, mucous membrane) would be contaminated with virus as would the regional lymph nodes, which drain these tissues. So exchanging the blood volume wouldn’t purge the body of the virus.

Ian Frank, professor of medicine and Director, Clinical Core, University of Pennsylvania Centre for AIDS Research:

There is no way to delay the effects of AIDS by removing infected blood and transfusing in uninfected blood. HIV replicates predominantly in a type of lymphocyte called a CD4+ T cell, or a helper T cell. About 2% of the CD4+ T cells in our bodies are circulating in the blood. The rest are in our intestines or in lymph nodes scattered around our body. Therefore, even if we could remove all of the HIV infected lymphocytes in our blood, the vast majority of the cells infected by HIV would not be removed, and HIV would still be reproducing in those cells.

Hope that is understandable. [Ed.: lol]

THE VERDICT: No, you can’t cure (or even ameliorate) HIV/ AIDS with blood transfusions, because the virus hangs out elsewhere in the body, and would just reinfect the new blood.

Original article via Gawker

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Discussion:

Have you read any interesting articles about measures to halt, or cure HIV/AIDS.  Why do you think the answer has baffled scientists for so long.  Do you think they’ll ever be a cure, or a vaccine for HIV, and when do you think HIV will begin to become part of history, rather than a current medical condition.  Comments are open for two weeks.

You may also be interested in:

 

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A Cure for HIV/AIDS Has Got a Step Closer!

Posted on August 2, 2012 by | Comments Off

Listen to this article instead


HIV is an exceptional adversary. It is more diverse than any other virus, and it attacks the very immune cells that are meant to destroy it. If that wasn’t bad enough, it also has a stealth mode. The virus can smuggle its genes into those of long-lived white blood cells, and lie dormant for years. This “latent” form doesn’t cause disease, but it’s also invisible to the immune system and to anti-HIV drugs.

When the virus awakens, it can trigger new bouts of infection – a risk that forces HIV patients to stay on treatments for life. It’s clear that if we’re going to cure HIV for good, we need some way of rousing these dormant viruses from their rest and eliminating them.

Now, a cure for HIV/AIDS has got a step closer after scientists found that a common cancer drug can purge the disease as it lies dormant in the body.  Current treatments are effective at reducing levels of the disease in the bloodstream – but a drug that can ‘knock out’ the disease when it lies dormant is thought to be key to a cure.

A team of US scientists led by David Margolis has found that vorinostat – a drug used to treat lymphoma – can do exactly that. It shocks HIV out of hiding. While other chemicals have disrupted dormant HIV within cells in a dish, this is the first time that any substance has done the same thing in actual people.

At this stage, Margolis’s study just proves the concept – it shows that disrupting HIV’s dormancy is possible, but not what happens afterwards. The idea is that the awakened viruses would either kill the cell, or alert the immune system to do the job. Drugs could then stop the fresh viruses from infecting healthy cells. If all the hidden viruses could be activated, it should be possible to completely drain the reservoir. For now, that’s still a very big if, but Margolis’s study is a step in the right direction.

HIV enters its dormant state by convincing our cells to hide its genes. It recruits an enzyme called histone deacetylase (HDAC), which ensures that its genes are tightly wrapped and cannot be activated. Vorinostat, however, is an HDAC inhibitor – it stops the enzyme from doing its job, and opens up the genes that it hides.

It had already proven its worth against HIV in the lab. Back in 2009, three groups of scientists(including Margolis’ team) showed that vorinostat could shock HIV out of cultured cells, producing detectable levels of viruses when they weren’t any before.

To see if the drug could do the same for patients, the team extracted white blood cells from 16 people with HIV, purified the “resting CD4 T-cells” that the virus hides in, and exposed them to vorinostat. Eleven of the patients showed higher levels of HIV RNA (the DNA-like molecule that encodes HIV’s genes) – a sign that the virus had woken up.

Eight of these patients agreed to take part in the next phase. Margolis gave them a low 200 milligram dose of vorinostat to check that they could tolerate it, followed by a higher 400 milligram dose a few weeks later. Within just six hours, he found that the level of viral RNA in their T-cells had gone up by almost 5 times.

These results are enough to raise a smile, if not an outright cheer. We still don’t know how extensively vorinostat can smoke HIV out of hiding, or what happens to the infected cells once this happens. At the doses used in the study, the amount of RNA might have gone up, but the number of actual viral particles in the patients’ blood did not. It’s unlikely that the drug made much of a dent on the reservoir of hidden viruses, so what dose should we use, and over what time?

Vorinostat’s actions were also very varied. It did nothing for 5 of the original 16 patients. For the 8 who actually got the drug, some produced 10 times as much viral RNA, while others had just 1.5 times more. And as you might expect, vorinostat comes with a host of side effects, and there are concerns that it could damage DNA. This study could be a jumping point for creating safer versions of the drug that are specifically designed to awaken latent HIV, but even then, you would still be trying to use potentially toxic drugs to cure a long-term disease that isn’t currently showing its face. The ethics of doing that aren’t clear.

Steven Deeks, a HIV researcher from the University of California San Francisco, talks about these problems and more in an editorial that accompanies the new paper. But he also says that the importance of the study “cannot be over­stated, as it provides a rationale for an entirely new approach to the management of HIV infection”.

Progress is being made every day, don’t believe us? – Check out the related articles below!

Original Articles via Discover Magazine and Mail Online

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I Am Living Proof That There Could Be a Cure For AIDS!

Posted on July 27, 2012 by | 1 Comment

Timothy Ray Brown, known as the “Berlin Patient” and the only person to have been cured of AIDS, holds a press conference to announce the launch of the Timothy Ray Brown Foundation at the Westin City Center hotel on July 24, 2012 in Washington, DC. “I wouldn’t wish this on my worst enemy,” Brown said of the treatment process that eventually cured him. Planned to launch during the International AIDS Conference being held in Washington, the foundation will work to focus efforts on finding a cure for HIV and Aids. — AFP Photo

The only person believed to have been cured of HIV infection through a bone marrow transplant said Tuesday he feels wonderful and is launching a new foundation to boost research toward a cure.

Timothy Ray Brown, 47, an American from Seattle, Washington, rose to fame as the so-called “Berlin patient” after doctors tried a novel technique to use an HIV-resistant donor for a stem cell transplant to treat Brown’s leukemia.

Since 2007, he has had two high-risk bone marrow transplants and continues to test negative for HIV, stunning researchers and offering new pathways for research into how gene therapy may lead to a more widely acceptable approach.

“I am living proof that there could be a cure for AIDS,” Brown told AFP in an interview. “It’s very wonderful, being cured of HIV.”

Brown looked frail as he spoke to reporters in Washington where the 19th International AIDS Conference, the world’s largest meeting of scientific experts, policymakers and advocates is taking place.

The bone marrow transplant he received carried significant risks and may be fatal to one in five patients who undergo it. But he said his only complaint these days is the occasional headache.

He also said he was aware that his condition has generated some controversy, but disputed the claims of some scientists who believe he may still have traces of HIV in his body and may remain infectious to others.

“Yes, I am cured,” he said. “I am HIV negative.”

Brown said he fully supports more aggressive efforts toward finding a universal cure, and has met with a number of top scientists in recent days who have treated him “like a rock star.”

He said he hopes to harness some of that fame to encourage donors to fund more research, and noted that Europe and China spend far more on cure research than the United States.

“There are thousands of very able researchers who cannot get funded for research, so I want to change that. And there are a lot of researchers who are willing to work to find a cure for HIV.”

Brown was a student in Berlin, Germany, when he tested positive for HIV in 1995 and was told he probably had about two years to live.

But combination antiretroviral therapy emerged on the global market a year later, and eventually transformed HIV from a death sentence into a manageable condition for millions of people worldwide.

Brown tolerated the medications well but due to persistent fatigue he visited a doctor in 2006 and was diagnosed with leukemia. He underwent chemotherapy, which led to pneumonia and sepsis, nearly killing him.

His doctor, Gero Huetter, had the idea of trying a bone marrow transplant using a donor who had a CCR5 receptor mutation.

People without that receptor appear to be resistant to HIV because they lack the gateway through which the virus can enter the cells. But such people are rare, and are believed to consist of one percent of the northern European population.

It would be an attempt to cure cancer and HIV at the same time.

Brown’s leukemia returned in 2007, and he underwent a bone marrow transplant using stem cells from a CCR5 mutation donor, whom he has never met in person. He stopped taking antiretrovirals at the same time.

He soon had no HIV detectable in his system. His leukemia returned though, and he underwent a second bone marrow transplant in 2008, using stem cells from the same donor.

Brown said his recovery from the second operation was more complicated and left him with some neurological problems, but he continues to be free of leukemia and HIV.

Asked if he feels like his cure was a miracle, Brown was hesitant to answer.

“It’s hard to say. It depends on your religious belief, if you want to believe it’s just medical science or it was a divine intervention,” he told AFP. “I would say it’s a little bit of both.”

Original Article

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Scientists Develop Nanoparticle Which Completely Destroys Hepatitis C

Posted on July 24, 2012 by | 1 Comment

Estimates suggest over 250,000 people in the UK have been infected with hepatitis C, but eight out of 10 don’t know they have it because they have no symptoms. About 75% of these people go on to develop a chronic hepatitis.

Because it can take years, even decades, for symptoms to appear, many people (possibly 100,000 or more) remain unaware they have a problem. By the time they become ill and seek help, considerable damage has been done to the liver. This might have been prevented if the person had been diagnosed earlier.

Elsewhere in the world, hepatitis C is even more common – the World Health Organization estimates that three per cent of the world’s population (about 170 million people) have chronic hepatitis C and up to four million people are newly infected each year.

While there’s increasing progress towards finding a reliable vaccine, results can’t come soon enough. Now, researchers have developed a nanoparticle that effectively eradicates hepatitis C 100 per cent of the time.

Researchers from the University of Florida have developed what they call a “nanozyme”. Based around gold nanoparticles, these things have their surface coated with two biological agents. One is an enzyme that attacks and kills the mRNA which allows hep C to replicate, while the other is a short string of DNA which identities the disease and sends the enzyme off to kill it.

While current hep C treatments attack the same replication process, they only work on about 50 per cent of patients treated. In lab-based tests, reported in the Proceedings of the National Academy of Sciences, the Univeristy of Florida researchers showed that their approach was 100 per cent effective in both cell cultures and mice. They observed no side effects in the mouse models, either.

While it’s great news, such a treatment is some way off becoming available to patients any time soon. All targeted drugs have to be extremely carefully tested, as there’s always a risk that they could also end up targeting healthy parts of the body by accident. Given the current problems posed by hepatitis C, though, that testing can’t happen soon enough.

Original Articles via BBC, Gizmodo, PNAS & IEEE Spectrum

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Together We Will End AIDS

Posted on July 23, 2012 by | Comments Off

Entitled Together we will end AIDS, the new UNAIDS report contains the latest data on numbers of new HIV infections, numbers of people receiving antiretroviral treatment, AIDS-related deaths and HIV among children. It highlights new scientific opportunities and social progress which are bringing the world closer to UNAIDS vision of zero new HIV infections, zero discrimination and zero AIDS-related deaths.

The report also gives an overview of international and domestic HIV investments and the need for greater value for money and sustainability.

Calling for global solidarity and shared responsibility, the UNAIDS report contains commentaries from global and community leaders as well as people living with and affected by HIV.

Download here

Link to UNAIDS Campaign 

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Nobel laureate, discoverer of HIV, says a cure for HIV is in sight!

Posted on July 21, 2012 by | 1 Comment

Photo: REUTERS/Bob Strong
Françoise Barré-Sinoussi is the Nobel laureate who co-discovered the HIV virus.

The Nobel laureate who helped to discover HIV says a cure for AIDS is in sight following recent discoveries, in an interview with AFP ahead of AIDS 2012, the global conference for HIV.

Francoise Barre-Sinoussi, who won the Nobel Prize in Medicine in 2008 as part of a team that discovered the human immunodeficiency virus (HIV), said scientific research was zeroing in on a cure for the illness.

She cited a patient in Berlin who appears to have been cured through a bone marrow transplant, “which proves that finding a way of eliminating the virus from the body is something that is realistic.”

Interested in that story? – it’s fascinating, here’s the links :

Other sources of optimism are the small minority of patients — less than 0.3 percent — who exhibit no symptoms of the virus without ever receiving treatment; and a small group in France who received antiretroviral drugs and now live without treatment or symptoms, Barre-Sinoussi said.

“There is hope… but don’t ask me for a date because we do not know.”

She also said that it would be possible “in principle” to eliminate the AIDS pandemic by 2050, if barriers to drug access could be eliminated.

The main barriers there were not scientific but political, economic and social, she said: the problem was lack of access to testing and drugs in poor and rural areas, as well as the stigma around the virus, which undermines early detection and treatment.

Some 25,000 people — including celebrities, scientists and HIV sufferers — are expected in the US capital on Sunday to call for more strident global action to address the three-decade AIDS epidemic.

Deaths and infections are down in the parts of the world most ravaged by the disease, while the number of people on treatment has risen 20 percent from 2010 to 2011, reaching eight million people in needy countries.

However this is only about half the people who should be on treatment worldwide, suggesting much more remains to be done.

More than 34 million people worldwide are living with HIV, a higher number than ever before, and around 30 million have died from AIDS-related causes since the disease first emerged in the 1980s, according to UNAIDS.

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Even without a cure, the end of the AIDS pandemic is in sight

Posted on July 19, 2012 by | 1 Comment

A very bold statement to make in the run up to AIDS 2012, none the less, this is the view of Dr. Anthony Fauci, director of the National Institute of Allergy and Infections Diseases (NIAID )

NIAID director Dr. Anthony Fauci addressing the United Nations General Assembly special session on HIV/AIDS on 10June 2008.

Dr. Fauci was appointed Director of NIAID in 1984. He oversees an extensive research portfolio of basic and applied research to prevent, diagnose, and treat infectious diseases such as HIV/AIDS and other sexually transmitted infections, influenza, tuberculosis, malaria and illness from potential agents of bioterrorism. NIAID also supports research on transplantation and immune-related illnesses, including autoimmune disorders, asthma and allergies.  Dr. Fauci serves as one of the key advisors to the White House and Department of Health and Human Services on global AIDS issues, and on initiatives to bolster medical and public health preparedness against emerging infectious disease threats such as pandemic influenza.

Dr. Fauci has made many contributions to basic and clinical research on the pathogenesis and treatment of immune-mediated and infectious diseases. He has pioneered the field of human immunoregulation by making a number of basic scientific observations that serve as the basis for current understanding of the regulation of the human immune response. In addition, Dr. Fauci is widely recognized for delineating the precise mechanisms whereby immunosuppressive agents modulate the human immune response. He has developed effective therapies for formerly fatal inflammatory and immune-mediated diseases such as polyarteritis nodosa, Wegener’s granulomatosis, and lymphomatoid granulomatosis. A 1985 Stanford University Arthritis Center Survey of the American Rheumatism Association membership ranked the work of Dr. Fauci on the treatment of polyarteritis nodosa and Wegener’s granulomatosis as one of the most important advances in patient management in rheumatology over the previous 20 years.

AN END TO NEW INFECTIONS?

Three decades into the AIDS pandemic an end to new infections is in sight, according to Dr. Fauci.

“We don’t even know if a cure is possible. What we know is it is possible that we can end this pandemic even without a cure,”

Fauci told AFP in an interview ahead of the International AIDS conference 22nd -27th July in Washington DC, America.

Some 34 million people around the world are living with human immunodeficiency virus, which has killed 25 million since it first emerged in the 1980s.

The theme of this conference, which is held every two years, is “Turning the Tide Together,” and is based on experts sharing knowledge of the latest advances and how to best implement them in order to halt new cases of HIV/AIDS.

“We have good and effective treatments but we have to keep people on the treatments indefinitely in order to keep them well,” said Dr. Fauci, referring to antiretroviral drugs which have transformed a deadly disease into a manageable condition.

“When you have a very marked diminution of the number of new infections then you reach what we call and AIDS-free generation.”

Dr. Fauci said he did not expect any staggering breakthroughs to be announced at the conference, but that the gain would come though collaborating on ideas to speed progress by using the tools that practitioners have already at hand.

Otherwise, if progress continues at the present rate of reducing new infections worldwide by about 1.5 percent per year, the goal becomes too distant, he said.

Recent studies that tested antiretroviral drugs in healthy people as a way to prevent getting HIV through sex with infected partners have shown some promise, though getting people to take their medication daily had proven a challenge.

“The important thing is you have to take your medication,” Fauci said, noting that average HIV risk reduction in a study of men who have sex with men was just 44 percent.

The approach of treating healthy people with antiretrovirals is known as pre-exposure prophylaxis, and “is not for everyone,” Fauci said. “We have to selectively use it.”

The US Food and Drug Administration on Monday approved the first pill for HIV prevention, Truvada, despite concerns by some in the health care community that it could encourage drug resistance and risky sex.

Novel ways to boost testing are also good news, particularly with the recent US approval of the first at-home HIV test.

“It is so important in the quest to ending the AIDS pandemic to get as many people tested as possible. You can link them to care and get them on treatment. Anything that makes that goal easier would be an important advance.”

As far as an AIDS vaccine, Fauci said researchers have made “good progress” but “still have a long way to go.”

Experts are examining a trial done in Thailand that showed in 2009 modest efficacy of just over 30 percent, but is still considered a breakthrough and offers clues for future study into why some were helped and others were not.

Dr. Fauci also said he did not expect much concern to be raised over upcoming reports of the extent of drug resistance to antiretrovirals.

“People may think I am taking it lightly but quite frankly it is not a serious problem,” Fauci said.

He added that overall, AIDS research is “going well” even though “funding is restricted right now.”

And he expressed pride in the United States’ President’s Emergency Plan for AIDS Relief (PEPFAR), “which has really transformed how you can get people in low income countries to get on treatment care and prevention.”

The United States provides almost half the world’s funding for international HIV assistance, according to UNAIDS.

The International AIDS Conference is returning to the United States after more than two decades away due to a ban on travel and immigration by people with HIV that was lifted in 2008 and signed into law in 2009.

Fauci called those restrictive laws “unfortunate” and “embarrassing.”

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Computer Simulations Help Explain Why HIV Cure Remains Elusive

Posted on May 15, 2012 by | 2 Comments

A new research report appearing in the March 2012 issue of the journal GENETICS shows why the development of a cure and new treatments for HIV has been so difficult. In the report, an Australian scientist explains how he used computer simulations to discover that a population starting from a single human immunodeficiency virus can evolve fast enough to escape immune defenses. These results are novel because the discovery runs counter to the commonly held belief that evolution under these circumstances is very slow.

“I believe the search for a cure for AIDS has failed so far because we do not fully understand how HIV evolves,” said Jack da Silva, Ph.D., author of the study from the School of Molecular and Biomedical Science at the University of Adelaide in Adelaide, Australia. “Further insight into the precise genetic mechanisms by which the virus manages to so readily adapt to all the challenges we throw at it will, hopefully, lead to novel strategies for vaccines and other control measures.”

To make this discovery, da Silva used computer simulation to determine whether, under realistic conditions, the virus could evolve as rapidly as had been reported if the virus population started from a single individual virus. This was done by constructing a model of the virus population and then simulating the killing of virus-infected cells by the immune system, along with mutation, recombination and random genetic changes, due to a small population size, affecting viral genes. Results showed that for realistic rates of cell killing, mutation and recombination, and a realistic population size, that the virus could evolve very rapidly even if the initial population size is one.

“A cure for HIV/AIDS has been elusive, and this report sheds light on the reason,” said Mark Johnston, Editor-in-Chief of the journal GENETICS. “Now that we know HIV rapidly evolves, even when its population size is small, we may be able to interfere with its ability to evolve so we can get the most out of the treatments that are developed.”

Original Article via MedicalNewsToday.com

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