HIV research looks to the future

Aids medication increasingly involves fewer pills with less side effects Keystone Archive

Swiss researchers have been discussing the latest advances in the science and treatment of HIV/Aids with their counterparts from around the world.

As an international conference in Paris drew to a close, they spoke to swissinfo about their hopes of checking the disease and even finding a vaccine.

Amalio Telenti, who heads the HIV unit at Lausanne University, said one of the most exciting developments in basic science in the past year had been the discovery that infected cells contain mechanisms to fight the virus.

“We have always known about protection by the immune system,” he said. “Now we are beginning to understand that when the virus enters the cell, the cell has the means to go and attack and try to block the virus.”

“This is a new field, very innovative, and will probably shed light on how the virus uses and abuses the human cell machinery to achieve its purpose and how the body actually tries to fight it in the home environment of the cell.”

Another technique, which is attracting a lot of interest, is called RNA interference.

RNA – a close cousin of DNA – has shown promise in deactivating out-of-control genes in cancer and halting the reproduction of viruses such as hepatitis or HIV.

Guiseppe Pantaleo, director of the division of immunology at Lausanne University Hospital, said the focus of Aids research in the next five to ten years would be on a vaccine.

“We already have very effective drugs. A vaccine is going to provide the solution to the disease, mostly for developing countries.”

Antibodies

Pantaleo is particularly intrigued by research in the United States, which is trying to stimulate the production of antibodies that are able to block the entry of the virus within the body’s cells.

Experts agree that new drugs have changed the face of the disease in western Europe and the United States.

“Basically one does not die of Aids any more here,” said Bernard Hirschel, who heads the HIV unit at Geneva University medical school.

In the past few years, attention has focused on the development of medications which are less toxic and easier to take – often because they involve fewer pills each day.

Daniel Berman of Médecins sans Frontières said simplified diagnostics and drug taking also had significant implications for developing countries.

“You could administer treatment to large numbers of patients with very little monitoring.

“Using drugs with lower side-effects means you could move treatment out of the hospital and into the village clinic, and I think that’s a big innovation for Africa that’s going to allow us to bring treatment to more people.”

Rates of infection

As for containing new infections, the picture is mixed, with a fair degree of success in western Europe and the United States, as well as countries like Brazil, Uganda, Thailand and Senegal.

On the other hand, there are many places where rates of infection have exploded. It is estimated, for example, that about five million South Africans are infected with HIV.

Crucial to all this is the commitment of the international community to the Global Fund to fight Aids, tuberculosis and malaria.

So far the fund has only received a fifth of the $10 billion (SFr13.8 billion) a year it was hoping for.

Berman said that in those countries where the money was being delivered, it was making a significant difference to the fight against HIV/Aids.

swissinfo, Vincent Landon in Paris

Aids

UNAids says 42 million people worldwide are living with HIV/Aids.
About 70 per cent (30 million) live in sub-Saharan Africa.
Another 17 per cent live in Asia.
The virus has killed 25 million.
By 2010, 45 million more will be infected if the pandemic continues at its current pace.
UNAids predicts 70 million deaths by 2020.