ShareThisScientists at major medical centers in the United States, the drug industry and AIDS advocates are calling for a new research effort to defeat, once and for all, the viral infections that have caused the global AIDS epidemic.
Worldwide more than 2 million people die from AIDS each year, despite the antiviral drugs that are keeping other millions alive..
More than 33 million people around the world are now living with HIV infections or AIDS, according to the United Nations, but only 4 million are receiving the drugs -- of whom 1 million are in the United States.
Scientists are searching for a path that would free every infected patient in the world from both the AIDS-causing virus and from life-long dependence on the drugs that can hold the virus at bay. So far the drugs are too costly for most of the underdeveloped nations of the world.
In a sense, the call for a collaborative effort to end to the viral infection is a voice from beyond the grave of AIDS advocate Martin Delaney, founder and longtime director of San Francisco's Project Inform, who died six weeks ago of liver cancer.
Before he died, Delaney, whose organization remains a major source of information, advocacy and activism on behalf of AIDS patients around the globe, had joined the scientists in meetings to draw up plans for what they are terming a "collaboratory," the coordination of years of research in a new venture with an unpredictable payoff.
As successful as they are in combating the AIDS virus, the drug combinations now available cannot eliminate every virus particle from the bodies of those who are infected. Those dormant particles pose an ongoing threat of renewed infection without lifelong use of those antiviral drugs.
The scientists' ultimate goal is to find new ways to purge those latent virus particles and thereby forestall permanent dependence on those overwhelmingly expensive drugs.
In their challenge to AIDS researchers worldwide, the U.S. scientists have published a review paper in the journal Science with Delaney listed as co-author.
Other authors include Douglas D. Richman of the University of California, San Diego; Warner C. Greene of the University of California, San Francisco's Gladstone Institute of Virology and Immunology; Daria Hazuda of pharmaceutical giant Merck; Roger J. Pomerantz of the Johnson and Johnson company; and David M. Margolis of the University of North Carolina.
Their paper is titled "The Challenge of Finding a Cure for HIV Infection."
By killing virtually all the latent viruses in the cells of infected people -- even in those who live in good health while taking the anti-viral drugs -- the researchers hope the immune systems of those who are infected would be empowered to cope with any few virus particles that remain without ever requiring more antiviral drug therapy.
"The big question," said Greene in an interview, "is how do we turn against a silent virus when we can't kill it until it expresses itself? It calls for a fundamentally different approach to cure the HIV infection, and it's an extremely tough goal that may not even succeed."
The idea for the new approach had its origin in 1996, when combinations of then new drugs called protease inhibitors were shown to be highly effective in suppressing virus infections and returning even sick AIDS patients to apparently healthy lives -- as long as they continued the drugs.
Since then expensive "cocktails" of three or more drugs have become standard in what is known as HAART, for Highly Active Anti-Retroviral Therapy, and only two years ago three of those drugs were combined into a single pill taken once a day. But the cost remains high, and few if any nations in the developing world can afford them for their millions of people living with HIV infections or with AIDS itself.
E-mail David Perlman at dperlman(at)sfchronicle.com.
(Distributed by Scripps Howard News Service, www.scrippsnews.com.)
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