5 HIV Treatment Strategies

In 2006, 25 years after AIDS made its first appearance in the CDC's Morbidity and Mortality Weekly Report, an estimated 2.9 million people died of the illness. That same year, more than 4 million people were infected with HIV, joining the 35.2 million living with HIV/AIDS. Despite the dozens of approved treatments for the disease, resistance and side effects are never far behind, and millions of people need new therapies to help them live with HIV/AIDS, not die from it. On the next several pages, you'll find five approaches that researchers say could do just that, or even prevent the disease entirely.

One, the first oral treatment that prevents the virus from entering uninfected host cells (see "The best offense?"), got a stamp of approval from the FDA last month: The agency approved the first CCR5 inhibitor, Pfizer's maraviroc, on August 6. In June, a European Medicines Agency committee also recommended its approval.

Vaccines, whether used as treatments or for prevention, remain a hot area of research. On "A piggyback attack," , we describe how some scientists are using adenovirus to deliver HIV genes; on "Reconstructing early HIV," we tell the story of other researchers who are hoping that ancient strains of the virus will yield new immunogens.

Structural biologists will be pleased to learn that their discipline, by filling in the missing pieces of what happens as HIV invades the cell, could reveal a chink in the virus's armor (see "Solving the viral spike"). Stem cells have made their mark here, as well, as researchers try to transduce anti-HIV genes into T cells (see "Stem cells and gene therapy").

Whatever the drug delivery strategy within the body, the world still needs to come up with a strategy that delivers drugs to those who need them. The George W. Bush administration pledged $15 billion in spending to Africa from 2003 to 2008, and recently asked Congress to double that commitment to $30 billion from 2008 until 2013. "AIDS is no longer a death sentence for those who can get the medicines," former US president Bill Clinton once said. "Now it's up to the politicians to create the 'comprehensive strategies' to better treat the disease."

I applaud the diligence and perseverance of those seeking a cure for HIV infection. I'm also disappointed by the cleverness of the virus in eluding them thus far. Also, I don't believe I've seen any statistics on the infectivity of those individuals on treatment, and outwardly well (and able to resume sexual or drug-seeking activities), but with some residual viral load. Are we possibly contributing to the spread of the virus by not completely eradicating it?

Mr. Clinton is right. The AIDS should no longer be a death sentence for those who can get the medicines. For this matter, the ideal state of medical science demands that no disease should be a death sentence for those can get the proper treatment.
Ofcourse, hope is more important than the all else. It lets us go, it lets us survive against adversities and it lets us go on working to find better solutions.