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Aids expert predicts long wait for a vaccine

Study leader Giuseppe Pantaleo says the vaccine will take years to perfect Keystone

The first trials of Aids vaccines in Switzerland got underway at Lausanne University Hospital during the summer.

swissinfo spoke to Professor Giuseppe Pantaleo, one of the leaders of the study, to find out what stage the research had reached and his hopes for finding an effective vaccine.

Pantaleo directs the Aids immunopathology laboratory, which is working together with the European consortium, EuroVac, to develop a vaccine against Aids.

Over the past few months an initial version of the vaccine – which does not contain the HIV virus itself but another, non-reproducing, virus – has been injected into several volunteers in Lausanne and London.

The initial phases of the trial are designed to test the body’s tolerance to the vaccines and whether their presence induces the immune system to respond.

Later, the vaccines will be tested on the Aids virus itself using volunteers who are already infected.

swissinfo: In recent years there have been repeated announcements of new drugs, new cures, new vaccines… Don’t we risk raising false hopes?

Giuseppe Pantaleo: In my view we need to make a distinction. The vaccine is still a long way off and will take many years to perfect. Moreover, we still don’t know how to induce antibodies that are capable of preventing the onset of the HIV virus.

That’s why we are working on vaccines that stimulate a cellular response. So although we don’t expect the vaccine to be able to prevent the infection, an HIV-infected person who has been vaccinated should be able to stop the reproduction of the virus and thus keep the infection under control.

As regards treatment, Aids has progressed from being an illness that rapidly leads to death to one that is merely chronic. The survival time for Aids measured from the moment of infection is currently 15-20 years, if not longer. From the therapeutic standpoint, therefore, the advances that have been made are truly incredible.

swissinfo: Cases of Aids are on the increase. Why is prevention no longer working?

G.P.: The problem is that the genuine efficacy of the treatment has caused people to drop their guard and take many more risks than they would have done a few years ago when these drugs were not available and the survival time was very limited.

The result has been an increase in new cases over the past two or three years. Institutions need to relaunch some highly aggressive prevention campaigns, which have been completely lacking in recent years.

Today, Aids has been “normalised” and has become a disease that is not so very different from other viral infections like hepatitis B or C.

swissinfo: This may be true for our society in the Western world, but can the same be said for Africa or Asia, where funding for treatment is lacking?

G.P.: This is a very important point. I would say that the problem of Aids no longer exists, or at least is extremely limited and well controlled, in the Western world.

The serious problem is in the developing nations, where the HIV infection rate in some countries is now around 25-30 per cent and primarily involves the younger sections of the population.

swissinfo: You say that from a medical standpoint Aids is a disease like any other because we now have effective therapeutic tools to deal with it. What about the side effects and costs of these treatments?

G.P.: The anti-Aids drugs themselves are effective. But it is certainly no easy matter for an HIV-infected individual to keep taking the treatment as directed year after year. Of course, these effects may be more or less severe, but it is difficult to interfere with the functioning of one part of the body – the cells, for example – without producing a corresponding dysfunction.

As regards the costs, we need to make one thing clear from the outset: pharmaceutical firms are private companies and one of the main objectives of the private sector is to yield financial profits. Asking a company to renounce this objective doesn’t make sense. It is true that the treatments are expensive, but it is also true that the cost of taking a drug from the laboratory to market can amount to some $200 million even if everything runs smoothly.

swissinfo interviewer: Doris Lucini, Lausanne

At the end of 2002 more than 42 million people were infected with HIV.
Over 65% of HIV-infected individuals live in sub-Saharan Africa.
90% live in developing countries.
There were 3.1 million deaths from Aids in 2002.
The percentage of patients in Asia and Africa with access to retroviral drugs is less than 5% (source: United Nations).
In Switzerland there was a 25.5% increase in the number of HIV cases in 2002 compared with the previous year.
792 new cases of infection have been registered.

Giuseppe Pantaleo was born in 1956, the son of a pathology professor at the University of Bari who specialised in immunology. He ended up following in his father’s footsteps and enrolling as a medical student.

After graduating in 1982, Pantaleo moved to Lausanne, where he worked for five years as a researcher at the Ludwig Institute for Cancer Research. He then decamped to the United States, before returning to Europe in 1995.

Pantaleo is currently working at Lausanne University Hospital, where he directs the immunology department and the Aids immunopathology laboratory.

Aids (acquired immune deficiency syndrome) is caused by HIV (human immunodeficiency virus), which destroys the body’s immune system.

There is no cure but combination drugs can slow the damaging effects of HIV on the immune system.

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SWI - a branch of Swiss Broadcasting Corporation SRG SSR