Separating Hype from Research on HIV/AIDS

HIV AIDS, AIDS virus

This blog regularly covers news surrounding HIV/AIDS, and where the disease currently stands in medical research and treatment. Once a polarizing diagnosis with a likely death sentence, HIV/AIDS has evolved into a treatable disease, although still one with numerous issues and side effects.

As part of our coverage on infectious diseases this week, we had the pleasure to speak with top researcher and physician Sagar A. Vaidya of Harvard Medical School and the Ragon Institute at Mass General Hospital to ask him to differentiate between the media hype and what’s truly happening with HIV/AIDS research.

How close are we to having an AIDS vaccine? What steps do we need to overcome to get there? 

Unfortunately, we are still many years away from the point at which an effective HIV vaccine would be available to use on a population level. The good news is that several recent advances have been made in understanding the role of broadly-neutralizing antibodies and T-cell responses against the HIV virus. This is our focus at the Ragon Institute, and the hope is that research on these topics will reveal new ways to target HIV and prevent or eliminate infection.

There are new reports about the HIV virus mutating and becoming more virulent. What are your thoughts on that? 

There were a few reports in 2013 about particular recombinant strains of HIV that are potentially more virulent or cause faster disease progression. These strains are limited to specific regions of Russia and Africa and it is unclear if they will spread. The new strains are still susceptible to existing anti-retroviral medications, so anyone who is diagnosed can be treated. Overall, the incidence of new HIV-1 infections is going down, which speaks to the success of enormous global efforts for HIV treatment and prevention.

Do you think this is a dangerous thing to say given that AIDS is still considered a pandemic? 

Despite the decrease in worldwide incidence, on an absolute basis the number of people infected with HIV is increasing yearly — since there is no cure — so I don’t think it’s incorrect to say HIV is still a pandemic.

The word “cure” has been used a lot in the mainstream press lately. How close are we to finding the “cure”?

The recent focus on the “cure” is simply the evolution of the amazing accomplishments in HIV research over the past 30 years. We’ve developed phenomenal new medications to prevent viral replication and keep patients healthy. The next step will be to find novel strategies to eliminate the HIV virus from the body completely, such that infected patients won’t need to take anti-retroviral medicines. It’s quite a challenge given that HIV can lie hidden, dormant in the DNA of many types of cells for years despite effective therapy. Even bone marrow transplantation, which destroys the body’s entire immune system before replacing it with a new one, failed to “cure” the virus.

Where would you like to see AIDS research focus? Where do you think the “nearest” win is? 

I think the greatest lesson from this past year is from a study done by the Centers for Disease Control and Prevention (CDC), which reported that in the U.S. only one of every three persons infected with HIV is prescribed treatment, and only one of four has the infection under control. Can you imagine a statistic like that for other disease, such as cancer, only 25% getting effective treatment? HIV can certainly be just as lethal.

Somehow there appears to be a major disconnect regarding HIV treatment on a societal level that we must fix. Simply put, everyone needs to be tested for HIV, everyone who tests positive needs to be encouraged to start treatment, and healthcare providers need to be more pro-active. I’m confident that we will eventually find both an HIV vaccine and an HIV cure, and it’s our job to make sure that our patients are still around to benefit when we do.

BIO:
Sagar A. Vaidya, M.D., Ph.D., is an Instructor at Harvard Medical School and an infectious disease physician at the Massachusetts General Hospital (MGH). His research at the Ragon Institute of MGH, MIT, and Harvard is focused on the role of inflammation in HIV. You can follow him on Twitter @drsagaravaidya.

Please read our other posts this week, all focused on infectious disease:

We are discussing this topic inside our physician community. If you’re an M.D. or D.O., please join us for a more detailed conversation.

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