New approach against HIV virus 'holds promise'

The first human trial of a new type of HIV therapy suggests it could be a promising weapon in the fight against the virus. A report in the journal ‘Nature’ shows that infusions of so-called ‘broadly neutralising antibodies’ could suppress the amount of HIV in a patient’s blood. The approach uses clones of immune proteins taken from a rare individual who has natural control of the disease. Scientists hope that, with further work, this approach could bolster current treatments. ‘Profound effects’ People naturally mount a defence against the HIV virus by producing an army of protein based weapons - antibodies. But in most cases these are not powerful enough to defeat it. The international research team harvested copies of unusually potent ones, capable of neutralising many different strains of HIV. Patients given the highest concentrations were able to fight the virus for some time, dampening the replication of HIV in their blood. The strength of this protection varied - in some it lasted more than four weeks. In the journal the authors said: “Our data establish that passive infusion of single broadly neutralising antibodies can have profound effects on HIV viraemia in humans”. But because of the virus’ ability to mutate rapidly, in some patients it was able to outwit the therapy by changing structure over time. To overcome this, scientists suggest using this treatment alongside current drugs or together with other antibodies. ‘Immune jolt’ Prof. Michel Nussenzweig of the Rockefeller University in New York, said: “This is different to treatment out there already on two counts. “First, because it comes from a human – so it is natural in that respect. And, secondly, it opens up the possibility of giving the patient’s own weakened immune system a jolt”. “One part of the antibody could act as a red flag – pointing out to the body where the virus is hiding and sending signals to kill it.” They are now exploring whether the infusion could shield people from getting the disease in the first place. But he cautioned that studies into the antibody are still small and at an early stage. “What this trial is telling us is that it is now time to look at the possibilities –from prevention and treatment to even cure,” he said. Commenting on the findings, Prof. Vincent Piguet from Cardiff University, said: “This exciting novel study shows for the first time that antibodies may have a place in the line of therapies directed against HIV.” He described it as an “important development in the fight against HIV” but said the costs of antibody therapy and the emergence of resistance must be taken into account. Local experts react Dr Placide Mugwaneza, Director of HIV Prevention Unit at Rwanda Biomedical Centre urged caution, saying that any form of HIV treatment cannot be trusted until it gets approval from the World Health Organisation(WHO). “Scientists keep discovering potential HIV treatments but each comes with it’s weaknesses. Up to now we have not got a perfect replacement for ARVs,” she said. Alvin Majyambere, a HIV researcher attached to MedPlus Clinic, Kimironko, said massive clinical and human trials for HIV treatment were necessary, to confirm their effectiveness. He added that even if such a treatment was approved by WHO, other aspects like cost and compatibility with other drugs will determine whether some countries will use it. Rwandan efforts Rinda Ubuzima, an NGO largely made up of local HIV researchers, started clinical trials about four years ago on a vaginal gel thought to prevent HIV. The results of the trial are yet to get published. Statistics from the Ministry of Health show that, on average, one person is infected with HIV every 30 minutes in the country. The current prevalence of HIV/Aids in the country among adults aged 15-19 has remained at 3 per cent in the last five years, estimated at 206,000 of the total population. HIV prevalence among children is about 1,000. However, it’s still high among the female sex workers (FSWs), at 51 per cent. By the end of 2013, the country had registered 48 per cent success in eliminating new infections and reduced the number of infected people from five to two per hour in the last five years. According to Dr Sabin Nsanzimana, the head of HIV, STI and Other Blood Borne Infections Division at the Rwanda Bio Medical Center, the government intends to raise condom use by 13 per cent, decreasing the estimated new infections in children from 1,000 to less than 200 and increase the fraction of male adult circumcision from 13 per cent to 66 per cent by 2018. The 2013-2018 National Strategic Plan against HIV/Aids has three main areas of intervention, including prevention of new infections by two-thirds from an estimated 6,000 per year to 2,000, care and treatment to halve the number of HIV-related deaths. Global stance HIV remains a major global public health issue, having claimed more than 39 million lives so far, according to WHO statistics. In 2013, 1.5 million people died from HIV-related causes globally. There were approximately 35 million people living with HIV at the end of 2013 with 2.1 million people becoming newly infected with HIV in 2013 globally. Sub-Saharan Africa is the most affected region, with 24.7 million people living with HIV in 2013. The same sub-region accounts for almost 70 per cent of the global total of new HIV infections. HIV infection is usually diagnosed through blood tests detecting the presence or absence of HIV antibodies. There is no cure for HIV infection. However, effective treatment with antiretroviral (ARV) drugs can control the virus so that people with HIV can enjoy healthy and productive lives. In 2013, 12.9 million people living with HIV were receiving Anti Retroviral Therapy (ART) globally, of which 11.7 million were receiving ART in low- and middle-income countries. The 11.7 million people on ART represent 36 per cent of the 32.6 million people living with HIV in low- and middle-income countries. Paediatric coverage is still lagging in low- and middle-income countries. In 2013, less than 1 in 4 children living with HIV had access to ART, compared to over 1 in 3 adults. editorial@newtimes.co.rw

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New approach against HIV virus 'holds promise'