New collaborations offer hope for HIV/AIDS vaccine

[Ekhi]

New collaborations offer hope for HIV/AIDS vaccine

EurekAlert
February 21, 2005

WASHINGTON, DC - Prospects for a safe, effective AIDS vaccine are improving as researchers from the public and private sectors begin to collaborate in new and creative ways, researchers said today at the 2005 Annual Meeting of the American Association for the Advancement of Science (AAAS). According to the Joint United Nations Programme on AIDS (UNAIDS) approximately 39 million people are living with HIV, and an estimated 4.9 million people were newly infected with HIV in 2004 alone.

New vaccines take decades to create, and the process can be slowed down when researchers work independently. Another reason that we don't have an AIDS vaccine yet is that making drugs for patients already infected with the virus has generally taken top priority.

"Given the magnitude of the AIDS epidemic and the complexity of the virus, the world must continue to galvanize resources to develop new prevention technologies, most importantly a vaccine," said Seth Berkley, president of the International AIDS Vaccine Initiative. "An effective AIDS vaccine is our best hope to stop the spread of HIV." Anthony S. Fauci M.D., director of the National Institute of Allergy and Infectious Diseases, said that for the National Institutes of Health, the new paradigm requires expanding beyond basic research. It involves a new focus on product development through alliances with the pharmaceutical industry and other research agencies.

"At NIH we are attempting to we strike a balance between the time-honored goals of pursuing basic scientific research as the true foundation of all our objectives, and the need for applied research, and novel research partnerships, to rapidly develop vaccines, therapies and other interventions," he said

Differences in study design and research methods can make it difficult to get the most out of vaccine trials as they are currently done, Fauci said. The leveling-off of NIH's research budget has added to the need for greater coordination and data-sharing among studies, so that results from a clinical trial conducted in one country could, for example, be better applied in another country. To that end, Fauci said, NIH and other agencies are also coordinating research protocols, standards and measures. "Our new role is not just doing basic research but also getting important countermeasures to the public."

"Partnerships between governments, industry and multilateral organizations can make a substantial difference in advancing AIDS vaccine research and development," said Berkley. "A model effort is the partnership across Asia, Europe and the United States in conducting India's first-ever human clinical trial of a vaccine."

New types of collaborations for global health are catching on outside of AIDS vaccine research as well. The journal Science, published by AAAS, recently listed the growth of public-private partnerships for AIDS and other public health research as one of the top ten research advances for 2004, saying that "A revolution in public health is fundamentally shifting the way medicines are developed and delivered to the world's poorest people." (Science, 17 December 2004)



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[Menydh]

New Therapies May Expand AIDS Arsenal - Conference

Reuters

February 25, 2005

WASHINGTON (Reuters) - Several new drugs work well in HIV patients who are beginning to run out of options because their virus has mutated into drug-resistant forms, researchers reported on Friday.

Adding new therapies to the 20 medications that already exist to control the AIDS virus is essential to keeping patients alive and healthy, because the virus almost always does mutate eventually, AIDS experts say.

And now that patients are starting to transmit drug-resistant infections directly to one another, it is more important than ever to have new drugs to suppress the virus, researchers told the 12th Annual Retrovirus Conference in Boston.

"I think in today's arena any new agent is being considered as an addition to the armory," said Dr. Mario Stevenson of the University of Massachusetts.

Combinations of HIV drugs called highly active antiretroviral therapy or HAART work very well to suppress HIV and keep it from damaging the immune system so badly that patients develop AIDS. But resistance develops eventually in many if not most patients.

Then new drugs are needed, and they must be different enough from the old drugs to avoid what is called cross-resistance.

One drug, still called by its experimental name TMC-114 by Tibotec, a subsidiary of drugs and personal products giant Johnson & Johnson, suppresses the virus well in patients who have been taking HAART for a while and who have developed resistance, the conference heard.

Dr. Richard Haubrich of the University of California, San Diego and colleagues tried a new cocktail in 497 patients, all but 100 or so of whom got varying doses of TMC-114, a new member of a drug class called protease inhibitors, with various other drugs.

The highest dose suppressed the virus back down to desirable levels, he told the meeting.

"This really shows remarkable results," Haubrich said in a telephone interview.

A second Tibotec drug called TMC 278 is in a class called non-nucleoside reverse transcriptase inhibitors or NNRTIs.

An international team tested 47 men who had never taken any HIV drugs with varying doses of TMC 278 for a week. It suppressed the virus and allowed immune system cells to recover, they reported. Now the team, lead by Frank Goebel of Ludwig Maximilians University in Munich, Germany, is testing the drug in patients who are failing in their current HAART regimens.

Dr. Susan Little of the University of California San Diego and colleagues tested Merck's experimental drug in a new class of HIV drugs called integrase inhibitors. They help prevent the virus from infecting new cells.

Called L-000810810, the drug was tested in 30 HIV-infected patients. It worked effectively and safely both in patients who had taken HAART and stopped and those who had never taken any drugs, they told the meeting.


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[Menydh]

Life-Prolonging AIDS Cocktails Show Real Value

Reuters

February 25, 2005

WASHINGTON (Reuters) - Drug cocktails that can prolong the lives of people infected with the AIDS virus are beginning to show their value but only about half of U.S. adults who should be receiving them are actually getting them, scientists reported on Friday.

The study was presented at a meeting in Boston of AIDS researchers at the 12th Annual Retrovirus Conference.

Dr. Rochelle Walensky and colleagues of Harvard Medical School and Brigham and Women's Hospital in Boston estimated how many people had been helped by the combinations of HIV drugs called highly active antiretroviral therapy or HAART, which can suppress the virus.

Although they are not a cure, have toxic side effects and often stop working after a while, they have added 1.78 million years of life to people who had progressed to AIDS, Walensky told the conference.

"When you start adding the numbers and get big numbers, you realize how much progress there has been," Walensky said in a telephone interview.

"We intentionally did our best to make this conservative," she added. They covered the time between 1989 and 2002.

Adding in the estimated 2,800 babies who were saved from HIV infection by treating them and their mothers at delivery added another 186,000 years of life saved, she said.

Eyasu Teshale and colleagues at the U.S. Centers for Disease Control and Prevention estimated that 480,000 Americans aged 15 to 49 should be getting treated with HAART, but only 268,000 are.

Since learning that HAART cannot eliminate infection, doctors usually wait until the AIDS virus has seriously damaged a patient's immune system before starting therapy.

ONLY 55 PERCENT GETTING TREATED

"Using the largest set of national data available, we estimated that only 55 percent of eligible people living with HIV/AIDS age 15 to 49 years old are receiving antiretroviral therapy in the United States," they told the conference.

"Most of those persons who are not receiving treatment, it's because they have not been diagnosed," said the CDC's Dr. Ron Valdiserri. In another study Dr. Geraldine McQuillan and colleagues at the National Center for Health Statistics found that HIV infection is not becoming more common among adults aged 18 to 59 in the average U.S. household.

They compared two surveys, one taken between 1988 and 1994, and another taken between 1999 and 2002, which both included blood samples from groups considered representative of the U.S. population, excluding the military, homeless and prison inmates.

They found the earlier prevalence at 0.33 percent of the population and the 1999-2002 prevalence was 0.43 percent. "These numbers are statistically basically the same," McQuillan said in a telephone interview.

But numbers of blacks doubled, from just over 1 percent of those surveyed to just over 2 percent and McQuillan said it was mainly among the oldest group, those aged 40 to 49.

"Since we are not seeing increases in youngest age groups, you feel comforted that prevention messages are at least being heard," McQuillan said.

The CDC estimates that overall, 850,000 to 950,000 people in the United States are infected with HIV, including as many as 280,000 who do not know it.

In 2003, an estimated 18,000 Americans died of AIDS. Globally, 39 million people are infected and 3.1 million people died of AIDS last year, according to the United Nations.


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