The Star Online: Lifestyle: Health
The Star Online: Lifestyle: Health |
| Posted: 11 May 2013 06:18 PM PDT Prof Françoise Barré-Sinoussi, who won a Nobel prize for her work in first identifying HIV, tells The Star that she believes there will be a cure for the virus that causes AIDS by 2050. She will chair the upcoming 7th International Aids Society (IAS) conference from June 30 to July 3 in Kuala Lumpur. THE 1980s saw the reign of showy prints, big shoulder pads and baggy parachute pants that look like you could stash your weekly supply of Twinkies. Beyond its zesty-neon façade, the era harboured a new terror that was quickly seeping into its psyche. It was the year 1981 when the United States became the first country to recognise that there was a strange new disease that was causing terrible and mysterious symptoms in clusters of gay men and injecting drug users (IDUs). These symptoms include dementia, extreme diarrhoea, staggering weight loss and weakness, and were afflicting young and apparently healthy adults. The public reaction to the phenomenon had been largely adverse, with many attributing the condition to an issue of morality. This reaction has undoubtedly contributed to the establishment of the disease, known today as the acquired immunodeficiency syndrome (AIDS), as among the most politicised, feared and most controversial medical conditions of our time. In 1983, French virologist Prof Françoise Barré-Sinoussi finally put a name to what was causing the symptoms, when she discovered (with her former mentor, Luc Montagnier) that the human immunodeficiency virus (HIV) was the cause of AIDS. Prof Barré-Sinoussi, now the director of the Regulation of Retroviral Infections Division (Unité de Régulation des Infections Rétrovirales) at the Institut Pasteur in Paris, recounts making the discovery that would alter the course of modern medical science. It was nearing springtime, about a year after her research on the virus began, when she finally managed to isolate the HIV virus and made a link between HIV and the AIDS disease that resulted from it. "I didn't know myself about this emerging disease before. I didn't know that the people who were dying were young, and that they were dying in terrible conditions. It was something really frightening, to tell you the truth," the 65-year-old virologist shares with this writer at an interview held in Kuala Lumpur. She was here recently to consolidate the list of events that will take place at the upcoming 7th International Aids Society (IAS) conference. She recalls the fracas that quickly ensued her discovery of the HIV virus, which revealed an urgent need for diagnostic tests to assist in controlling the spread of the disease. "The feeling right after we discovered the virus was: "Let's rush! We knew it was an emergency and when you are in an emergency like that, you don't have time to think," she says. Their early findings showed that the virus was transmitted by blood and through the sexual route, as well as from mother-to-child. But there was still a lot of work to be done, in terms of characterisation and identifying the biological traits of the virus, as it was new, so nothing was known, she points out. It wasn't until the advent of 1985 when Prof Barré-Sinoussi and her team began to realise that Africa was already strongly affected by the disease. "It was only then that we started to realise that this was something truly frightening for everyone," she says. Prof Barré-Sinoussi started her own laboratory at the Pasteur Institute in 1988, an endeavour that would become a lifelong passion for the professor. Among her more recent research contributions include studies on the various aspects of the adaptive immune response to viral infection, factors involved in mother-to-child transmission of HIV, and characteristics that allow a small percentage of HIV-positive individuals, known as "elite suppressors or controllers", to limit HIV replication without antiretroviral drugs. The virologist has also co-authored over 240 scientific publications, participated in over 250 international conferences, and has trained many young researchers. At the international level, Prof Barré-Sinoussi has been a consultant to WHO and UNAIDS-HIV. Since the 1980s, she has initiated collaborations with several developing countries. In 2008, she was awarded the Nobel Prize in Physiology or Medicine, together with her former mentor, Montagnier, for their discovery of HIV. The following year, she wrote an open letter to Pope Benedit XVI in protest over his statements that condoms are at best ineffective in the AIDS crisis. In July 2012, Barré-Sinoussi became president of the IAS. The professor continues to work towards establishing permanent links between basic research and clinical research, with the aim of achieving concrete improvements in the areas of prevention, clinical care and treatment. She will chair the upcoming 7th IAS conference, the world's largest open scientific conference on HIV/AIDS, in Kuala Lumpur. The conference, which will be hosted in Asia for the first time, will take place from June 30 to July 3. The IAS conference represents a worldwide platform for the examination of the latest developments in HIV-related research and is expected to attract some 5,000 scientists, clinicians, public health experts and community leaders from around the world. This year's installment will focus on the HIV epidemic in Malaysia, as well as the Asian region, providing local stakeholders the opportunity to discuss all the latest progress in the field, as well as challenges that are specific to Malaysia itself. According to the United Nations in a Reuters report, "an end of the worldwide epidemic is in sight, mainly due to better access to drugs that can both treat and prevent the incurable HIV virus that causes the disease." Prof Barré-Sinoussi is optimistic of the possibility. "In principle, we know from scientific evidence that if we are successful in the universal access to treatment that we have today, then we know that we should be able to end the AIDS epidemic by 2050," she says. However, Prof Barré-Sinoussi is cautious: "The word 'cure' means a total clearance of the virus, or to totally eliminate the virus from the body. This is going to be very, very difficult; almost an impossible mission. "This is because the virus can be present in different compartments of the body – in the blood, in different tissues, in the brain. As such, it is very difficult for drugs to reach all the cells that can carry this latent virus." She elaborates: "The problem now is, if you stop treatment, the cells will be activated. When that happens, the virus multiplies again and will spread into other cells. "Hence, if a patient stops treatment and starts again, they will likely risk the emergence of resistance to treatment, and the patient will be required to change the combination of treatment. "At present, we have some evidence that says that we should be able to develop what we call a 'functional cure' in the future. This means that you don't eliminate the virus totally, but you have a permanent contour of the virus, even when the patient stops the treatment. "With a permanent contour, the patient will remain with a low level of the virus, even without treatment and he or she will not transmit to others." But such treatment may yet be elusive to the masses, she says. "It can only be possible if everyone who is infected by HIV is on treatment. Is that feasible? We have to ask ourselves – how are we going to reach everyone? "Of course, we are all fighting and will continue fighting for access to antiretroviral treatment for people all over the world. This will get us as close as possible to the goal of endng AIDS." Prof Barré-Sinoussi has taken to heart the ideals of the institute's founder, French chemist and microbiologist Louis Pasteur, since the beginning of her career. Pasteur himself is remembered for his breakthroughs in the causes and prevention of diseases. "His idea, really, was that there are no frontiers in science. Science is there for the benefit of humankind and it is exactly what we are doing in the field of HIV/AIDS, and in the field of other human diseases. We should continue pushing boundaries in the spirit of Pasteur. "My dream is certainly to make sure that everyone is on treatment, whether it is novel treatment or the current treatment that we have today. "I dream that people living with HIV have sufficient care and treatment and that there will be no more mother-to-child transmissions. "If I can leave this world and know that there is a cure or vaccine, I will be relieved. But for now, it is the simple goal of eliminating mother-to-child transmission that I hope to achieve. Because for me, mother-to-child transmission is just not unacceptable." Related Stories: |
| Posted: 11 May 2013 06:20 PM PDT IN the 30 over years since the scourge was first identified, over 30 million people around the world have died from AIDS-related illnesses, and twice as many have been infected with the HIV virus. HIV attacks the immune cells and can be transmitted from an infected person to another through blood, semen, vaginal secretions and breast milk. These cells become progressively damaged over time. When that occurs, the body becomes increasingly vulnerable to infections, which it will have difficulty fighting off. It is at the point of a very advanced HIV infection that a person is said to have AIDS. If left untreated, it can take up to 10 years before the HIV virus does enough damage to the immune system for AIDS to develop. In 2011, there were an estimated 3,500 new HIV cases in Malaysia, averaging nine new infections every day. Statistics from the Diseases Central Unit in the Malaysian Health Ministry from the same year showed that an alarming 45% of all new HIV infections occurred from heterosexual sexual transmission; 10% from homosexual/bisexual sexual transmission; 38% from injecting drug users; 2% from mother to child, and 5% from other causes. Despite its popular reputation as a "gay disease", the increasing number of heterosexual HIV transmission suggests that the future HIV epidemiological landscape will be one that is driven by heterosexual sexual transmission. But there is good news on the horizon. In a 2012 report, the United Nations was quoted saying that "Progress over the past decade has slashed the death toll and helped stabilise the number of people infected with HIV". The number of new HIV cases worldwide is also on a decline, the UN Aids programme revealed in its annual report in November. "Deaths from AIDS fell to 1.7 million in 2011, down from a peak of 2.3 million in 2005 and from 1.8 million in 2010. Worldwide, the number of people newly infected with HIV is also falling. In 2011, the number of new infections was at 2.5 million, which is 20% lower than in 2001. AIDS-related illnesses are also on a decline on the local front. The first HIV case was reported in Malaysia some 25 years ago, and has since claimed the lives of an estimated 15,000 people. As of Dec 2011, about 80,000 Malaysians are reportedly living with HIV However, the annual number of new HIV cases reported to the Health Ministry has fallen from a peak of 6,978 in 2002 to 3,479 new cases in 2011. Among the efforts that the Health Ministry has undertaken to help curb and manage the disease include providing free antiretroviral treatment to HIV patients. Although there is no known cure for AIDS, those living with HIV can take antiretroviral drugs to prevent or delay the onset of AIDS. |
| Posted: 11 May 2013 06:19 PM PDT ANTIRETROVIRAL treatment is the main type of treatment for HIV or AIDS. It is not a cure, but access to treatment can help stop HIV patients from becoming ill for many years, and can even help them live a "near normal" life. What antiretroviral treatment does is that it keeps the amount of HIV in the body at a low level. This stops any weakening of the immune system and allows it to recover from any damage that HIV might have already caused. The treatment consists of drugs that have to be taken every day for the rest of a person's life. Also, the drugs need to be taken at the same time(s) every day. Some people may experience serious side-effects such as nausea, vomiting, rash and diarrhoea, or may not respond to certain drugs. There are currently over 20 approved antiretroviral drugs. First and second line therapy At the beginning of treatment, the combination of drugs that is given to a patient is called first-line therapy. However, if the virus grows resistant to this combination over time, or if the side-effects are particularly bad, then a change to second-line therapy is usually necessary. Second-line therapy typically includes a minimum of three new drugs, with at least one from a new class, in order to elevate the likelihood of treatment success. In Malaysia, first-line antiretroviral therapy is fully subsidised, while second-line antiretroviral therapy is partially subsidised. Antiretroviral therapy is also available in prisons. Combination therapy Taking two or more antiretroviral drugs simultaneously is called combination therapy. Taking a combination of three or more anti-HIV drugs is often referred to as Highly Active Antiretroviral Therapy (HAART). If only one drug was administered, the virus would quickly become resistant to it and the drug would stop working. Taking two or more antiretroviral drugs at the same time can significantly reduce the rate at which resistance would develop, making treatment more effective in the long term. Some antiretroviral drugs have been merged into one pill, which is known as a "fixed dose combination". This reduces the number of pills that a patient has to take every day. The choice of drugs to be administered depends on a number of factors, including the price and the availability of drugs, the number of pills, and the side effects of the drugs. In the developing world, most people living with HIV still have very limited access to antiretroviral treatment and only receive treatment for diseases that occur as a result of a weakened immune system. Such treatment only has short-term benefits because it does not address the underlying immune deficiency. |
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