Cure for AIDS may be not that far off

AIDS was once considered a virtual death sentence. Scientific advances have turned it into a manageable disease. Now there’s reason to hope that final victory — a vaccine preventing infection, and an actual cure — may be possible in the foreseeable future.

The struggle against AIDS and HIV, the virus that causes AIDS, has taken place for 35 years. The gloom of the early days began to dissipate in the mid-1990s when effective anti-HIV drugs were discovered.

And the discoveries keep coming. Vaccine researchers keep finding weak spots in HIV vulnerable to powerful “broadly neutralizing” antibodies. Last week, another weak spot, the seventh discovered so far and the third this year alone, was reported. All three have been identified by teams including scientists from The Scripps Research Institute in La Jolla, a major center of vaccine research.

AIDS researchers who have worked in the field from the beginning, such as Dr. Anthony Fauci, marvel at the change in patient survival that anti-HIV drugs have accomplished.

“In the early ’80s, the median survival time of my patients was six to eight months,” said Fauci, director of the National Institute of Allergy and Infectious Diseases. “Today, if a 25-year-old comes into the same clinic that I took care of them 30 years ago … you can project they will live another 50 — that is five-zero — years.”

This staggering transformation of one of the most relentless diseases into something that can be lived with bears evidence that the expenditure of billions of dollars and untold hours of research and treatment are paying off.

HIV has been attacked from nearly every conceivable angle, from drug therapy to discouraging risky behavior. Public health programs such as providing condoms and promoting education about avoiding high-risk behaviors complement the medical and scientific advances in understanding and blocking HIV.

And under a program called PEPFAR, created in 2003 by President George W. Bush, lifesaving HIV drugs have been sent abroad to impoverished populations who can’t afford them.

The result of this kitchen-sink approach, Fauci said, is that over the past 10 years, the number of deaths from HIV worldwide has dropped 35 percent, as has the number of new infections.

And while no effective vaccine is available, creative use of drugs to block AIDS infection provides the next best thing. Using what is called “pre-exposure prophylaxis,” medication is given to those at high risk, such as non-monogamous gay men and intravenous drug users, who can pass along fluids containing HIV.

“If you give them one pill a day of a drug called Truvada, you can dramatically diminish the likelihood that they will be infected,” Fauci said.

Treating infected people to bring their viral levels below the limits of detection also greatly lessens the chance they will pass along HIV to an uninfected partner.


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