What it will take to achieve an AIDS-free world
London: Leading researchers and clinicians united together at a conference to discuss recent findings that could bring hope to the estimated 35 million people world-wide who live with HIV and to identify what needs to be done before an AIDS-free world can go from dream to reality.
Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases at the National Institutes of Health in the US, began the meeting by suggesting that, for a cure to work, it must be safe, simple, and scalable.
Fauci discussed the feasibility of an AIDS-free world on the basis of scientific advances in preventing infections in those not infected and preventing illness in those who are infected. Preventive strategies include, among many others, the expansion of HIV testing, circumcision, treatment as prevention, and prevention of mother-to-child transmission.
Before speakers examined the advances in these biomedical interventions, a number of researchers spoke of one of the largest roadblocks to a cure: the latent reservoir, which consists of viral DNA that inserts itself into the genome of infected patients' cells, without replicating.
Perhaps the most widely discussed option for a cure has been the hope of a vaccine. A number of speakers discussed the various advances, and also setbacks, in the race toward successful vaccination strategies.
Nobel Prize winner David Baltimore of the California Institute of Technology noted, "We need a vaccine, but we still don't have an open road in front of us." The key, according to Baltimore, is to not follow models of traditional vaccines but, rather, to "think about the extremely exciting observations that have been made about the kinds of antibodies that patients make in response to a long-term HIV infection."
Speakers examined the various promising avenues toward developing an effective vaccine, including very recent work from Michel Nussenzweig and Dennis Burton on producing monoclonal broadly neutralizing antibodies in macaques.
The conference was hosted by the journals Cell and The Lancet.