The HIV story: When research faces setbacks, look to previous advances for inspiration
02.05.13
Last week marked the third meeting of the International HIV Treatment as Prevention Workshop. Bringing together stakeholders from policy, industry, academia, and civil society, the workshop examines priority areas of research and action related to the use of antiretroviral therapy (ART) and reduced HIV transmission.
Just 20 years ago, an event like this would have been unthinkable. At that time we were grappling with how to keep those infected with HIV from dying; today, we have developed medicines not only allowing those infected with HIV to live productive lives, but that also reduce transmission from infected to non-infected persons.
A Short History of Amazing Progress
It is essential to remember how far we have come in combating HIV – especially when we are faced with setbacks. Last week, the NIH announced it was halting a study of an experimental HIV vaccine that appeared to neither prevent infection, nor reduce the amount of HIV in the blood. The news was a blow.[1]
In such moments, we tend to forget how much progress we have made. The advances made in HIV research and medicines development is astounding and more intricate than can be discussed in a blog post. For now, consider this: On June 5, 1981 the US Centers for Disease Control and Prevention (CDC) published a report describing the appearance of a rare lung infection, alongside other unusual infections, in young previously healthy gay men in Los Angeles. Soon after, doctors across the US were flooding the CDC with reports of similar cases.
In February of 1983, Dr. Robert Gallo of the National Institutes of Health (NIH) first suggested that AIDS was probably caused by a retrovirus. A little over four years later, the FDA approved the first antiretroviral drug. In 1995, the first protease inhibitor was approved, opening the way to a new era of highly active antiretroviral therapy (HAART).
Another landmark moment was seen in 2011, when a CDC study (TDF2) and a separate trial, the Partners PrEP study, indicated that a daily oral dose of antiretroviral drugs could also reduce HIV acquisition for heterosexual partners. In December of 2011, the journal Science awarded its Breakthrough of the Year designation to the HPTN 052 study – an ongoing clinical trial which is further examining the extent to which ART can decrease infectivity.
Perseverance in the Face of ‘Failure’
When looking at the trajectory of how far HIV-related R&D has come, I am confident that we will continue to find new and improved ways of dealing with this difficult illness. Even now, researchers in Denmark are expressing optimism regarding a novel HIV treatment they are working on – 15 patients are taking part in trials of the treatment, which proved successful in laboratory tests.
Even “failed” studies like the one halted by NIH are of use: “Researchers need to unpack the data from this trial to understand more about why this strategy didn’t prevent infection,” Mitchell Warren, executive director of the nonprofit group AVAC: Global Advocacy for HIV Prevention, said in a statement. “It’s not the answer we hoped for,” he admitted “but the search doesn’t end here.” This is a reasonable view – and the right attitude to have.
The search for new and improved medicines is ongoing, challenging and certainly frustrating at times. In the face of a single defeat, however, we can be too quick to forget accomplishments. The history of HIV treatment development is an inspiring example of what science is capable of – and a reminder of what can come when we support medicines research and development as we should.
Learn More
International HIV Treatment as Prevention Workshop
A history of AIDS
