“Probably, we will need certainly a combination of treatment but for short term, so the patients can stop the treatment after a while –said Françoise Barré-Sinoussi, Nobel Laureate because she discovered HIV and IAS president-elect, answering to my question about the needs we still have to fi nd a cure for the HIV infection, and she was thinking aloud, considering the all 30 years of HIV history: to fi nd a cure means, in perspective, to define when to start therapy and when to stop or, better again, when to end.
During the IAS Conference in Rome, you launched a new IAS initiative that is called “Towards an HIV Cure” –as it was reported in the last HAART issue. In your talk you mentioned some proofs of concept that a cure is possible: elite controllers and the “Berlin patient”. You are the person who discovered HIV, so you are following the AIDS story since the beginning. This is the reason why I think you are in the best position to tell us what could be the recipe, what kind of ingredients we need to find a cure…
“Certainly, at the beginning the patient will need to be on HAART, the classical HAART, especially we need to treat very early the patient on HAART, so that is the reason that we have to still stimulate, promote HIV testing for everyone because if someone is positive he/she can benefi t very early on HAART. Then, when the patient is on HAART and the viral load is controlled, we can think about a combination of treatment that can target specifically molecular mechanisms that explain why the virus remained dormant, latent into the cells, in order to rescue the virus from the cells. Since the patient will be on HAART, the virus will not be able to infect other cells.
But it is not enough for the cure…
We know that the persistence is due to the fact that the virus is dormant into the cells, particularly the TCD4 cells, and we know that the survival and the proliferation of these cells when the virus is dormant is an important mechanism for latency. For a cure we will have certainly also to target the cells for inhibiting the proliferation of infected cells or to stimulate the patient’s immune response, in order to eliminate the cells that are infected.
After rescue of the virus, if we have vaccine therapy, for example, if the patient has strong suppressive CD8 response as soon as the virus will be expressed, the cells will be targeted by the CTL and be killed, but that will be feasible in my opinion in patients treated very early on HAART. That’s the combination of treatment, to be short.
You are going to became the President of the International AIDS Society, so in some way, as you dressed in Cape Town the T-shirt “HIV positive”: you are becoming an activist of research…
I mean…as a scientist… you mentioned that I am a scientist and an activist, and I am both indeed because, working since the very early years of HIV, like many scientists, I have been fighting to try to provide scientific evidences for the benefit of the patients and we did. We did because we have a treatment. And we know today that the treatment is even prevention. As scientists, how we can accept to have been so much mobilized to try to be reactive as fast as possible for the benefit of the patients and to see today that patients, not all of them, can benefit of the success of science? This is not acceptable for us, so is the reason why a scientist can become activist.
Articolo presente in – HAART and correlated pathologies n. 12 –
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