The Future of AIDS
Trial and Error Plagues HIV Prevention and Treatment
The 2.5 million people infected with human immunodeficiency virus (HIV) last year have few new options for treatment. Prolonging the onset of acquired immunodeficiency syndrome (AIDS) has become more difficult as the AIDS virus becomes resistant to treatment. Clinical trials for new therapies have been unsuccessful and prevention methods have been plagued with noncompliance, but researchers are still studying ways to prevent the progression of HIV infection to AIDS.
HIV Infection Prevalence
According to estimates from the U.S. Centers for Disease Control and Prevention, which were based on information gathered from surveys between 1999 and 2006, 0.47% of 18-49 year olds were infected with HIV during that time. The data is roughly equivalent to the prevalence from 1988-1994, indicating that the American household prevalence of HIV has not changed in 20 years. The estimates do not take into account new HIV infections, known as the incidence, and with the prolonged life span of AIDS patients the estimates may indicate a decreased incidence.
It is estimated that 25 million people have died from AIDS, the final stage of HIV infection, since the virus was discovered in 1981. There is no cure, no vaccine, and limited treatment options. The most popular current treatment is antiretroviral therapy (HAART), but the virus has been exhibiting increasing resistance to this therapy via mutation. Patients have to adhere to a strict medication schedule, often taking more than three medications, in order to decrease the chances of mutation. Prevention, often summed up as condom use, is still the most effective method of decreasing the occurrence of HIV infection.
Prevention with a Gel – The Caraguard Trial
Caraguard is a microbicide gel derived from seaweed. Microbicides destroy microbes such as viruses. The gel was developed by a nonprofit organization in New York as a new HIV prevention method. Caraguard was tested in 6,000 African women, the epicenter of the AIDS epidemic, but it was found to be ineffective due to misuse or noncompliance.
Only 44% of the women in the study actually used the vaginal gel, and only 10% of the women adhered to the given directions. The researchers are still trying to evaluate if any of the data can give an indication to the effectiveness of the compound if it were to be used correctly. One positive outcome to the study was some evidence as to the safety of the prevention method and increased condom use due to the additional HIV education given to the participating women.
Avoiding Viral Resistance – Suppressing Replication
Researchers from Pennsylvania State University and the National Human Genome Research Institute in Maryland reported in the April 28 edition of NatureNews that they had discovered a protein within human T cells, the main immune cell attacked by HIV. Knocking out the protein suppressed HIV replication. Targeting the human immune system itself could possibly avoid further drug resistance. The research group has filed for a patent and is optimistic that this finding may benefit those suffering from autoimmune diseases, such as asthma, in addition to AIDS patients. The treatment would not be a preventative measure, but a new treatment.
Turning the tables on HIV and utilizing the body’s defenses is a renewed hope in AIDS research. However, prevention is still key, and education necessary to curbing the millions of new infections occurring each year. Research is continuing on a vaccine, the PAVE 100 vaccine trial is set to follow Merck’s recent failure, but condoms and safe-sex education is currently the only prevention method.
