During these 40 years of history of the illness more than 40 million people have died of AIDS the world over, 60,000 of them in Spain. There are currently 38 million HIV-infected people in the world, according to the WHO. Every year, AIDS causes a million deaths and some 700,000 people become infected. In the first ten years of AIDS in the United States, HIV infection became the leading cause of death in people from 20 to 40 years of age.
The first treatment against AIDS, azidothymidine (AZT), appeared in the mid-eighties, but its effectiveness was limited. No efficient treatment was available until 1996, when a combination of antiretroviral drugs was developed that was able to supress replication of the virus. But no significant major advance would arrive until 2010, when drugs were created that were less toxic and easier to take. These are the integrase inhibitors, and they have transformed AIDS into a chronic disease. Today, many AIDS patients take just one pill a day and can lead a perfectly normal life. There is still no cure, however. Antiretroviral treatment is able to control replication of the virus very well, but not cure the infection.
Current HIV/AIDS research is focused on two major challenges:
Achieving a preventive or therapeutic vaccine against HIV.
Identifying a cure strategy that enables elimination of the virus in an infected patient.
Both challenges have accumulated years of promising research, but also failures. Why is it so complicated to design an effective vaccine against HIV? What stage has research and innovation reached around a possible vaccine? What are the main obstacles and differences in comparison, for example, to the new vaccines created against coronavirus? Why have they been able to design different COVID vaccines in twelve months, while the search for an HIV vaccine has been ongoing for 40 years without success? What makes HIV more complicated to attack and overcome than other viruses?
With regard to complete elimination of the virus from a patient’s body, as in the case of the Berlin patient and the London patient, what impediments exist to replicating this procedure in AIDS patients? Why is it so difficult to repeat the strategy followed with the London and Berlin patients? Finally and taking into account the international endeavours in research and innovation, how long before a cure or vaccine?
Dr Julià Blanco, group leader at the IrsiCaixa AIDS Research Institute of ”la Caixa” Foundation, and researcher at the Germans Trias i Pujol Research Institute (IGTP).
Dr Beatriz Mothe, doctor and group leader of the clinical research line of immunotherapies, vaccines and pharmacology of the Infectious Diseases Service, and associate researcher at the IrsiCaixa AIDS Research Institute of ”la Caixa” Foundation, at Germans Trias i Pujol University Hospital.
Marta Sugrañes, journalist and television presenter on TVE.