aidsnorthbay.com – AIDS Committee of North Bay & Area - To assist and support all persons infected or affected by HIV/AIDS and/or Hepatitis C and to limit the spread of the viruses through eduction, awareness and outreach strategies.
After years of research, the team from Temple University in Pennsylvania used their technique to eliminate the virus fromhuman cells by ‘snipping’ it out.
The successful experiments took place in the lab, but the team is confident the treatment could be trialled on humans within three years.
In a 2014 study, the researchers successfully managed to remove the HIV DNA from normal human cells.
This time around, they used the same technology to remove it from infected T-cells, which play a major role in the immune system, in a more accurate simulation of how the virus would be treated inside patients’ bodies.
During their studies, the team drew blood from people living with HIV. Their T-cells were cultured in the lab, and then treated with the Crispr/Cas9 gene editing system, in which a targeted protein uses enzymes to remove genetic sequences (in this case, HIV DNA) from cells.
Their results definitively proved it is possible to eliminate the virus and prevent it from re-infecting cells using this treatment.
However, using highly-detailed genome sequencing to analyse the treated cells, the scientists found they continued to grow and function normally, and didn’t appear to be suffering from any side-effects.
According to Kamel Khalili, the leader of the study: “The findings are important on multiple levels.”
“They demonstrate the effectiveness of our gene editing system in eliminating HIV from the DNA of T-cells and, by introducing mutations into the viral genome, permanently inactivating viral replication.”
Speaking to The Telegraph, Khalili said the study has “huge potential,” and added: “Based on the findings we should be entering into clincical trials within three years.”
A paper detailing their study has now been published in the high-profile Scientific Reports journal.
Health Canada has quietly approved an HIV drug as a preventative therapy to keep the virus at bay for people at high risk. Studies suggest that Truvada can cut the risk of HIV infection by 90 per cent, when taken before or after sex.
Gilead Sciences Canada, the makers of Truvada, say the federal agency approved the drug as a pre-exposure prophylaxis (PrEP). Doctors who run HIV/AIDS prevention clinics say the move is a leap forward in making therapy options more accessible.
“We should do everything in our power to enable the prevention of HIV, and that’s just the humane thing to do. It’s also the effective thing to do,” Dr. Isaac Bogoch, an infectious disease expert who runs one of Canada’s biggest HIV prevention clinics out of Toronto General Hospital, told Global News.
“I can’t tell you how happy I am. Now, we feel we have the blessing of Health Canada to do what we’ve been doing all along,” he said.
READ MORE: Pills before and after sex can help prevent HIV, study finds
Truvada is taken orally once per day. It contains two medications and it’s used as part of a drug cocktail regimen to treat HIV-positive cases. In this case, it’s being backed by Health Canada as a preventative measure.
If some patients are identified as “high risk,” they could use Truvada to stave off the virus. Those considered at high risk may have a partner who is HIV positive, or they could be engaging in “risky” behaviour such as unprotected sex with partners who may be exposed to HIV or sharing injection needles, Bogoch said.
It’s already been approved for PrEP in the United States as of 2012, as well as in Kenya and South Africa in 2015. It’s in the works in Australia, Brazil, Peru and Thailand, too.
READ MORE: HIV prevention drug approved in the US but not yet in Canada
Gilead Sciences told Global News last year that it applied for Truvada to be used as a prevention method in August 2015.
It was the first drug to be approved by the U.S. Food and Drug Administration to reduce the risk of HIV infection in high-risk populations. It’s also the first to receive the nod by Canadian officials.
“Multiple clinical trials have demonstrated that Truvada for PrEP is effective at reducing the risk of HIV infection acquired through sexual exposure,” Dr. Cecile Tremblay, of the University of Montreal’s department of microbiology, said in a statement.
“The number of new HIV infections in Canada has remained steady over the past several years and it is exciting to consider the potential impact of a new tool to help lower the rate of HIV infections in the future,” Tremplay explained.
READ MORE: Why the United Nations is adopting Canadian scientist’s HIV strategy
Right now, patients pay out of pocket or through private insurance for Truvada therapy, according to Dr. Jason Brunetta, who runs a prevention lab out of Maple Leaf Medical Clinic.
The drug comes with a hefty price tag – about $12,000 to $15,000 annually.
A Health Canada approval ushers in potential for provinces to provide funding to cover the drug.
“The official approval may improve access for patients. It may expand the reach and the availability of the drug,” Brunetta said.
READ MORE: A made-in-Canada health strategy is making waves worldwide – just not in Canada
There were about 2,570 new HIV infections reported in Canada in 2014, according to the Public Health Agency of Canada.
Canadian studies have suggested that Truvada taken daily as a precautionary measure could reduce the risk of HIV infection anywhere from 90 to 100 per cent.
“We know that if people are able to adhere with it pretty well, take their pill on most days, that it can achieve extremely high levels of protection, north of 95 per cent reduction in risk. One study even estimated something closer to 100 per cent reduction in risk,” Dr. Darrell Tan, an infectious disease physician, from St. Michael’s Hospital told Global News.
READ MORE: HIV isn’t easily transmitted by sex, Canadian doctors say
Past studies have looked at those who take a daily pill and what impact that daily dose has on prevention. Tan’s study, released last December, looked at what happened in high-risk populations that took the medication on an “on-demand” basis.
Participants took two pills hours or days before sex and two pills after, one at 24 hours and the next at 48.
The results suggested that those who took Truvada “on demand” were 86 per cent less likely to get infected.
There is no story in global health as transformative, awe-inspiring, and yet as tragic as the AIDS pandemic. The disease was unknown only a generation ago — a medical curiosity among young gay men in New York and San Francisco in June 1981.
Within a few short years, AIDS could be found on every continent, enveloping the world to become one of the most devastating pandemics in human history. It has caused untold human suffering, social disintegration, and economic destruction.
In the early days of the pandemic, public health officials relied on prevention strategies devised for other sexually transmitted diseases. This includes testing, counselling, education, condoms and partner notification.
Newly diagnosed people had an average survival period of six to eight months. And their weakened immune systems made them vulnerable to rare cancers, pneumonias, chronic fatigue and horrific wasting until death ensued.
The early years of fear, pain and despair
The socio-political response was, at best, denial, ignorance, and silence. Ronald Reagan, US President at the time, did not utter the word “AIDS” in public until 1986. At worst, it was social marginalisation, discrimination, and punishment. People were blamed for their own suffering and criminalised for their behaviour. The fear, pain, and despair faced by people living with AIDS and their loved ones cannot be overstated.
But by 2010, UNAIDS announced a goal that was once unimaginable: getting to zero. Zero new infections, zero AIDS-related deaths and zero discrimination.
The 2012 International AIDS Conference was held in the US for the first time in 22 years because the US restricted entry of persons living with HIV between 1990 and 2011. At the conference, then Secretary of State Hillary Clinton called for an AIDS-free generation. To be sure, these high hopes provoked a skeptical response, with experts saying the goal was unrealistic and open-ended. What exactly is the definition of “zero” or “AIDS-free,” and which generation are we talking about?
But stepping back from perennial debates about aspiration tempered by realism, it is impossible not to marvel at the technological advances that enabled global health leaders to say the unthinkable: that we may one day see the end of the scourge of AIDS.
Powerful technological interventions
The technological advances that made all this possible include, first and foremost,antiretroviral treatments. A newly diagnosed 25-year-old today can expect to live another 50 years on treatment. But it also includes combination prevention, which extends well beyond traditional methods of testing, counselling, condoms and education. These do remain vital.
Research has shown remarkable reductions in HIV transmission from male circumcision, pre-exposure prophylaxis (PrEP), and antiretroviral therapy.
At the 2011 International AIDS Conference, scientists announced a jaw-dropping 95% plus reduction in sexual transmission among heterosexual couples adhering to antiretroviral treatment.
What if it were possible to reach every person at risk, or already infected, with these powerful interventions? What if the next discovery could empower women to protect themselves, such as with a vaginal microbicide, which is on the horizon? Given the political will, isn’t it imaginable that the international community could “get to zero”?
How did all these technological advances come about, and why did this particular disease forge a pathway toward unprecedented scientific discoveries? Very sadly, science has not been able to match these technological advances for most global health challenges. Not mental illness, cancer, or tuberculosis.
It has been said that these are all highly complex, multi-factorial diseases, while AIDS is not. But this is far from the truth.
Social mobilisation like never before
AIDS is one of the most complicated and stubbornly persistent diseases the world has ever known. Yet the sociopolitical dimension of AIDS has galvanised perhaps the greatest social mobilisation around a health crisis that the world has seen.
From the AIDS Coalition to Unleash Power (ACT UP) and Lambda Legal Defense in the US to the Treatment Action Campaign in South Africa, courageous individuals and organisations have literally transformed the politics of AIDS, turning neglect and derision into empowerment and social action.
This vast social mobilisation was targeted not only at fighting the social dimensions of this disease with poignant calls for dignity, nondiscrimination, and justice. It was perhaps principally about access to medicines.
AIDS campaigns had crisp clarity, appealing to a basic sense of social justice: the rich have access to life sustaining medicines while the poor do not. This message resonated in developed countries where the poor often were denied access to antiretroviral medication. But it also resonated in developing countries where most people could not afford a life-saving pill that the majority of those in the developed world could access.
The access-to-medicines campaigns brought AIDS advocates to pursue solutions beyond the health sector. Activists directly attacked the prevailing trade liberalisation paradigm, which protects intellectual property, and asserted the higher priority of the right to health.
In South Africa the TAC successfully challenged the government’s restrictions on access to perinatal treatment before the Constitutional Court. At the international level, the AIDS movement energised the World Health Organisation to take access to medicines seriously. This prompted campaigns such as the World Health Organisation’s 3 by 5 initiative. It forced the World Trade Organisation to change course, introducing Doha Declaration flexibilities to soften a harsh intellectual property regime.
A global effort
This social mobilisation also unleashed unprecedented resources in global health — new funding for biomedical research, vaccines, and treatment. Moreover, social mobilisation around AIDS literally transformed global health governance. It fundamentally altered the foreign assistance of the most powerful countries. For example PEPFAR in the United States, and UNITAID, formed by Brazil, Chile, France, Norway, and the United Kingdom.
For the first time, the major powers began to frame an infectious disease as a national security threat, addressed at the highest political levels at the G8. Social mobilisation drove the United Nations’ response, prompting the first high-level summit ever held on a health issue to be devoted to AIDS.
A novel public-private-partnership emerged, outside the UN/WHO structure, to generate and pool resources — the Global Fund to Fight AIDS, Tuberculosis and Malaria.
Although the international community has rallied to fight AIDS, fierce debates have raged within the movement. Initially, advocates worried that traditional public health strategies such as testing and reporting would undermine privacy or foster discrimination. At the same time, policy makers debated which interventions — and in what combination — were most effective. And then there was the divisive issue of cost-effectiveness. Could governments afford expensive interventions such as lifetime treatment with antiretrovirals?
If not, how could the benefits be fairly allocated among the large population of persons at risk or living with HIV? And should the same level of resources devoted to AIDS be made equally available for other pressing health conditions, such as child/maternal health, injuries, or non-communicable diseases?
These battles ensued within both domestic health sectors and foreign health assistance budget debates. They remain topics of lively debate.
*This is the first of three articles drawn from the book Global Health Law, released by Professor Lawrence Gostin.
A drug designed to prevent people who are at risk of HIV from being infected is showing promise: a new real-world study found that those who took the drug stayed HIV-free. The finding adds to growing evidence the drug, PrEP, serves as an effective method of curbing the spread of the HIV virus.
For the study, the first to look at PrEP outside of a clinical setting, researchers evaluated more than 650 people who began the drug during a 32-month period. Nearly all of the participants were men who have sex with men. Users were more likely than non-users to report that they had multiple sex partners. During the study, participants developed a number of different sexually transmitted diseases but remained free of HIV.
The Food and Drug Administration approved PrEP for use in 2012 and it has since been recommended to groups that engage in sexual practices that place them at increased risk of HIV. The drug can reduce risk of HIV infection by 92% if taken properly, according to the Centers for Disease Control and Prevention (CDC).
HIV infection rates in the U.S. have persisted in recent years despite campaigns to raise awareness and encourage condom use.