5 Things We Learned from the International AIDS Conference
The idea of “treatment as prevention” also informed the discussion of Truvada’s recent approval to be prescribed as a preventive measure for HIV-negative people at high risk of contracting the virus. Some conference attendees questioned the wisdom of using the drug for prevention, given its cost, the possibility of side effects, and the danger that people taking it may become lax about safer-sex precautions. Harvard University researcher and conference presenter Douglas Krakower said, however, that he considers it irresponsible “to withhold strategies that may be protective.”
Cost is likewise a consideration with early initiation of treatment, as is the need to stay on the drugs faithfully; breaks in treatment can lead to the development of drug-resistant strains of HIV. But one study presented at the conference documented a group of patients in France who were treated early, went off their meds, and have seen the level of HIV in their bodies remain low. These results provide still more reason that “antiretroviral treatment should be started very early after infection,” said Charline Bacchus, lead researcher at the French National Agency for Research on AIDS and Viral Hepatitis.
A report about two Boston men who had achieved undetectable viral loads after receiving bone marrow transplants received much fanfare at the conference. The men, who have both been HIV-positive for several years, received the transplants as a treatment for cancer, but the procedures also had the effect of making HIV undetectable in their blood. Their cases differed from that of the so-called Berlin patient, Timothy Ray Brown (pictured above), who also achieved viral suppression following a bone marrow transplant. His was with stem cells that had a genetic mutation with resistance to HIV; the other men’s transplants involved cells without the mutation. Doctors at Brigham and Women’s Hospital think the Boston men’s HIV became undetectable because antiretroviral drugs, which they continued taking during the transplant process, helped keep the cells that repopulated their immune systems from becoming reinfected with the virus.
Both men remain on antiretroviral treatment, and doctors say it is too early to describe them as “cured” of HIV. Researchers plan additional studies, both to see if the men might have HIV in their tissues, if not in their blood, and to determine the effects of bone marrow transplants in other people with the virus. Brown, on the other hand, has been off anti-HIV drugs for several years and is what scientists consider “functionally cured.” At the conference, he announced he has started a foundation that will conduct research into a cure.
Others also have new optimism about a cure. The International AIDS Society, which sponsors the conference, has put together a strategy for seeking a cure, identifying key areas for research to make this possible. It announced the strategy just prior to the conference.
“The science has been telling us for some time now that achieving a cure for HIV infection could be a realistic possibility,” said French scientist Françoise Barré-Sinoussi (pictured above), who helped discover the virus, in announcing the project. “The time is right to take the opportunity to try and develop an HIV cure — we might regret never having tried.”