Will the global fight against HIV/AIDS rebound? For two and a half years, the COVID-19 pandemic has thwarted the fight against this infamous immune disease. But pharmaceutical advances related to the fight against COVID-19 are opening up new possibilities for prevention and cure.
Key to these developments, “we can even dream of curing HIV”, breathes Jean-Pierre Routy, doctor and researcher specializing in the disease at the McGill University Health Center (MUHC), who co-chairs the 24e International Conference on AIDS – the major global meeting of people in the field – which begins Friday in Montreal.
“It’s been three years since we had a congress [en raison de la pandémie]. People will be able to see each other in real life, rebuild their solidarity and their group spirit. Because we want to prevent all researchers studying AIDS from going to other fields, such as immunological treatments against cancer or COVID, “says Dr.r Routy, met in his lab at the MUHC a few days before the conference.
If the HIV/AIDS “high mass” is coming to the metropolis this year, it is largely thanks to this doctor-researcher who was able to raise millions of dollars in funding from governments here and elsewhere. . For him, the adventure takes on a special character: it is thanks to this conference, which was already held in Montreal in 1989, that he had the opportunity to obtain a position as a researcher in the field in Quebec. .
Hundreds of people are therefore converging on the Quebec metropolis to take part in this meeting, during which we will present scientific results, we will define the axes of research and we will try to find ways to take action.
“Re-engage” in the fight
On the sidelines of the conference, the Joint United Nations Program on HIV/AIDS (UNAIDS) presented in Montreal, Wednesday afternoon, its annual update on the progression of the disease on the planet. And the situation is not rosy: in 2021, we observed the smallest reduction in five years in the number of new infections in the world compared to the previous year (–3.6%).
“This report is a wake-up call as the HIV community gathers here in Montreal,” said Anthony Fauci, the US President’s top medical adviser, who participated in the report’s presentation via videoconference. “The conference theme — ‘Recommitting to AIDS and Following the Science’ — couldn’t be better,” he added.
At the very beginning of the COVID-19 pandemic, HIV treatment suffered from more difficult access to health care. Now, it is largely the decline in funding for the fight against AIDS that is the problem. In 2021, the international financial resources available for HIV were 6% lower than in 2010, notes the report of the UN body.
“Last year, in 2021, AIDS and related diseases claimed one life every minute,” UNAIDS Executive Director Winnie Byanyima said during the presentation. “And this, even if we have the necessary medicines to save these lives. »
Pharmaceutical hopes
These drugs are called triple therapy. They allow those who take them daily to live almost normally despite an HIV infection. Their use is widespread in rich countries. In Africa — the continent most affected by HIV/AIDS — 78% of people living with the virus benefit from it.
In parallel with efforts to offer triple therapy to all infected people, the pharmaceutical industry is working on new molecules.
Potential messenger RNA vaccines against HIV — which could prevent the disease or cure those infected — are currently undergoing phase 1 clinical trials in the United States. The company Moderna, which will build a factory in the Montreal region and which has signed a partnership with McGill University, has also developed one of the candidate vaccines.
Monoclonal antibodies—another class of drugs perfected to fight COVID-19—also hold great hope for the fight against HIV. “With the current triple therapy, we block the metabolism of the virus by neutralizing its enzymes; with monoclonal antibodies, we attack the virus directly, ”explains Dr.r Routy.
In theory, monoclonal antibodies have the ability to find infected cells (1 in 100,000) in the body and kill them. This would not only block the reproduction of the virus, but outright eliminate it. Rather than leaving the virus dormant thanks to triple therapy, we would get rid of it for good.
For now, messenger RNA and monoclonal antibodies are in separate clinical trials. If these trials prove conclusive, a synergistic use will be tested. “Everyone believes that only a combination of different approaches can work” to cure HIV, notes Dr.r Routy.
Pharmaceutical companies also have a special interest in getting involved in these new therapies with great potential: in a few years, their patents on triple therapy drugs will expire. Competitors will then be able to produce generic versions at a reduced price.