Evidence of a possible treatment for AIDS

Heyn July 22 The 25th week-long international AIDS The conference began in Munich. Although these rallies are no longer war councils as they were in the early days of the pandemic – for the sake of a strategy of defeat HIV It is now largely settled, and there is still much fighting to be done.

In a report issued at the start of the conference. UNAIDSThe United Nations agency dealing with the disease said nearly 40 million people are now infected. There were 1.3 million new infections in 2023, 630,000 HIV– Related deaths. But those numbers are down from 2.1 million and 1.3 million, respectively, in 2010. This year is the baseline for calculating the 90% decline in annual new infections and deaths. HIVassociated deaths, which experts believe will end AIDS As a threat to public health. The hope is to reach this goal by 2030. This seems unlikely given current trends. But the numbers, for the most part, are moving in the right direction.

Because sub-Saharan Africa was the most affected region in the world, most efforts were focused there. This has paid off. New infections there since 2010 have fallen by 56%. Partly as a result of this, UNAIDSFigures issued by the World Health Organization indicate that for the first time since the start of the pandemic, there have been more new infections outside this part of the world than inside it. However, there was another contributor to this shift, which occurred in three regions: Latin America; Eastern Europe and Central Asia; In the Middle East and North Africa – new infection rates have increased.

Although there is currently no cure, AIDS It can still end. This depends on two steps: treating those already infected and preventing transmission of infection to those who are not infected. Goals help, if only to clarify goals. for treatment, UNAIDS It publishes the easy-to-remember formula “95-95-95”. This translates into an aspiration that 95% of those infected are aware of the fact that 95% of this group take antiretroviral drugs to suppress the infection, and that of 95% of those treated in this way (i.e. 86% of those infected), the treatment succeeds in suppressing the viral load. Worldwide, the “treatment trifecta” is encouraging 86-89-93, with an estimated 30.7 million people taking antiretroviral drugs.

Most importantly – and this is where treatment and prevention are linked – people who take antiretroviral medications the way their doctor ordered them have minimal viral loads and are therefore less likely to transmit the infection. This situation,is known in the field Sh=Sh (undetectable = not transmissible), gives a combination of preventive methods (eg condoms, microbicidal vaginal rings, and various preventive drug regimens) a better chance of success.

The use of medications for pre-exposure prophylaxis, commonly called prophylaxis ppPeople’s Armywhich is a particularly promising approach. About 3.5 million people around the world take Truvada or Descovy, the first ppPeople’s ArmyTo be approved. But these pills only provide short-term protection, so they must be swallowed regularly. Long-term coverage comes from injections.

First injection ppPeople’s Army Cabotegravir, produced by ViiV Healthcare, has been approved by the US Food and Drug Administration (Food and Drug Administration) in 2021. This gives two months of protection, and a trial in Uganda showed that it is more popular than the pill. The second is lenacapavir, from Gilead Sciences, which also makes Truvada and Descovy. The meeting coincided with the publication of the full results from very-1, Experience this in South Africa and Uganda. very-1, which launched in 2021 and enrolled 5,300 women, was shown to provide 100% protection for six months. This is seen as a real breakthrough, and activists have called on Gilead to make it available cheaply.

Regarding the issue of treatment, some news announced before the conference aroused particular interest. This was the revelation of the seventh known person who had apparently received permanent forgiveness from him HIV Infection after a bone marrow transplant to treat leukemia. Bone marrow is the source of the immune system CD4 T– The cells that are attacked HIV. Therefore, in a few cases there was a leukemia patient as well HIVPositive, where surgeons intentionally look for a donor with a mutation in the gene T– It is called a cell surface protein CCR5 (which the virus uses to enter those cells), hoping to treat two diseases for the price of one disease. This is because HIV He finds it difficult to get infected T-Cells of people with the mutation CCR5 proteins.

What distinguishes the latest case, that of an unknown person known as the second Berlin patient (the first, Timothy Brown, was treated in the German capital in 2007), is that the donor had inherited this mutation from only one parent, i.e. half of the relevant protein molecules were in the marrow. Its bones are not transformed, and thus they remain HIV-friendly. Furthermore, news of the second patient in Berlin comes after an even more puzzling case reported last year from Geneva, where the donor was completely normal. CCR5 proteins.

A surprising development

All this suggests that something more complex is going on. Sharon Lewin, President of the International Organization AIDS The community organizing the meeting is a leading beacon in the search for a cure for a disease AIDS. She suspects that transplant preparations aimed at killing existing marrow in recovered patients, as well as the immune response of new marrow to remaining old marrow, shrink the reservoirs in which it resides. HIV Hides and gives CCR5 Helping hand boom.

Such a shrinkage of the tank, via special medications, is something you are already considering. Combined with infusion T– Genetically modified cells to inactivate them CCR5, may form the basis of treatment. ■

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