Mexico City: Patients infected with HIV might be able to live symptom-free without medicines as aggressive treatment with newer drugs better control the disease, the head of US infectious disease research said on Wednesday.
Giving hope: Anthony Fauci, director of the National Institute of Allergy and Infectious Disease in Bethesda, says a vaccine targeted at people with a specific genetic make-up may also be possible in two decades. Photograph: Bloomberg
While research on a vaccine continues, early treatment with the current AIDS drugs also could prevent some people from getting infected, Anthony Fauci, director of the National Institute of Allergy and Infectious Disease in Bethesda, Maryland, said at the International AIDS Conference in Mexico City. Scientists should conduct more studies to assess that theory, he said.
Current drugs reduce the amount of the virus in the body to undetectable levels, making HIV a treatable disease similar to diabetes or arthritis, Fauci said. Still, only one person is getting the drugs for every three people infected, he said. There were 2.7 million new infections in 2007, according to a July report by UNAIDS, and an estimated 33 million people worldwide have HIV, the virus that causes AIDS.
“A cure will likely require early diagnosis and treatment,” Fauci said. “Studies need to be done in the next few years to determine if very aggressive therapy early on will allow us to get a functional cure.”
Treating patients soon after they are infected may protect the immune system and suppress the virus so patients can slowly stop taking the drugs, Fauci said. Merck and Co.’s Isentress and other new classes of drugs may help do this, he added.
“I believe we will be able to, in some patients, not very many, eradicate HIV microbiologically and we will have a functional cure in others,” Fauci said. “But this will likely require aggressive drug regimens and rely on the timing of initiating therapy.”
A vaccine targeted at people with a specific genetic make-up may also be possible in the next two decades though two vaccine experiments failed, Fauci said. Merck ended development of its experimental AIDS vaccine last year after trials showed it was ineffective. The US government in July said it had stopped a test of its vaccine, which was similar to Merck’s product.
Some medicines already can be taken immediately following exposure to prevent infection in infants. Boehringer Ingelheim GmbH’s Nevirapine, in combination with other drugs, can reduce the risk of transmission from 30% to less than 2% between HIV-positive mothers and their infants.
AIDS treatments made by Gilead Sciences Inc. will be tested on healthy people to see if they can prevent the lethal disease, according to the AIDS Vaccine Advocacy Coalition, a New York-based group that promotes prevention. Pfizer Inc.’s Selzentry is being studied as a topical cream to prevent transmission.
Continued investment from the pharmaceutical industry, something that may be waning, is needed to develop the current drugs as preventative treatments, said Peter Piot, executive director of UNAIDS in a speech on Wednesday in Mexico City. By 2031, most patents on existing drugs will have expired, cutting into company profits.
“We have to make sure the drug development remains in step with the evolution of the virus and that industry continues to invest,” Piot said. “There are worrying signs that that isn’t the case and that is something we have to put on the table.”
More effective prevention methods that target men who have sex with men, sex workers and drug users also are necessary to reduce infection rates, Piot said. Health officials must communicate prevention messages more effectively, he said.
“No company will try to sell soap if they haven’t done research for the community they are trying to sell to,” Piot said. “It would pay off if we could bring that experience from the business world to our amateur approaches.”