Big AIDS News Coming This Week? Study May Suggest ‘Cure’ Is Close
Science magazine reporter Jon Cohen speaks with the Kaiser Family Foundation’s Jackie Judd about the willingness of scientists to discuss the possibility of a “cure” for HIV/AIDS.
Here, Cohen highlights a report that will be released later this week that may fuel that conversation.
The NewsHour is partnering with the Kaiser Family Foundation to bring you these video updates throughout the conference week. Check back for more soon. And of course, stay tuned to the NewsHour broadcast for further analysis throughout the proceedings.
Jackie Judd, Kaiser Family Foundation: Jon Cohen of Science magazine, welcome. The conference is a day-and-a-half-old, and the word keeps cropping up that scientists very much avoided in previous years: cure. We’re also hearing, of course, ‘The end of AIDS,’ the possibility. Why this change?
Jon Cohen, Science magazine: Because so much progress has been made. In treatment, we have a whole arsenal of really good drugs. And there’s ample evidence that if you use the drugs, people live for more than 50 years — extra years. And we also know that those drugs can prevent transmission. That leads to the whole concept of ending AIDS. We have the major tools — not those alone — but that really pushed it over the edge that we can do it.
Judd: When scientists here talk about a cure, what is their definition?
Cohen: That’s a great question and it’s a tricky thing. The ultimate cure would eradicate the virus from your body. All gone. But what if you could do something that made it such that your body could handle a very low level of the virus? We live with lots of viruses and bacteria that don’t harm us. So that’s called ‘the functional cure.’ And it’s an important distinction because eradicating the virus — completely getting rid of every infected cell — might be a pipe dream. But a functional cure is pretty tangible.
Judd: You have been briefed on a study that will be released later this week having to do with successes in that area. What did you learn?
Cohen: In the ‘functional cure realm,’ one idea is, ‘What if you caught people very close to the time they were infected and they started on antiretroviral drugs right away. This is a study that looks at 14 people who started treatment within 40 days of having become infected. It was done in France … and they found that after all these people started drugs, the virus became undetectable by standard tests, and the people opted to go off treatment. And it’s now seven years later on average and the virus hasn’t come back.
Judd: And they’ve not been on medication?
Cohen: Not on medication. Now they still have HIV in them. But they’re not on treatment.
Judd: They’re living healthy lives?
Cohen: They’re leading healthy lives. They seem to be doing fine. Now it could be that two or three or four years from now, the virus comes roaring back and they have to go back on treatment. There are people who are called ‘elite controllers’ who stay off treatment for 20 years and remain undetectable for 20 years on the standard tests. So one of the questions is: Are these people simply these ‘elite controllers’ and they just happen to have started treatment earlier?
Judd: And what’s the answer to that, do you know?
Cohen: Well that’s one of the coolest things about this study is they’ve kind of ruled that out. The elite controllers have markers on their cells – things they inherit that say, ‘I can really beat HIV. I’ve got a really good immune system. It recognizes the virus and just punches it and punches it. That’s why I’m an elite controller.’ These people don’t have that. What’s more, the markers they have on their cells are really hands-tied-behind-their-backs. They have a really weak immune system when it comes to HIV. It could be, ironically enough, that that’s what’s helping them. That remains to be seen. I know that sounds crazy and paradoxical, but…
Judd: And I presume that one theory is that if you catch someone very early, it may lead to people being able to live without medication?
Cohen: If this pans out, if it’s true, there may be a group of people who, when they start treatment really early, they save their immune system from damage that otherwise is irreparable. And those people, after they control the virus for a period of time can go off drugs and stay off drugs, and maybe take a drug holiday for three, four, five years. This has been done before and failed many, many times, so there have been studies that have looked at the same thing. What’s unusual…
Judd: By fail you mean the virus comes raging back?
Cohen: It came back. What’s unusual about this group is they have this immune marker that suggests that they’re more susceptible. So there’s something intriguing going on. And that’s where we are now at this point in the epidemic. All the low-hanging scientific fruit has been picked. We’re now going for that really high fruit that has a huge payoff. A cure is a dream. But it’s a really tough question to answer.
Judd: And we’ll hear more about it on Thursday.
Cohen: We’re going to hear more about it every day this week.
Judd: Thank you. Jon Cohen, Science magazine.
Watch many of the International AIDS Conference proceedings from Sunday and Monday in their entirety on our Health Page. Also there, find background materials including a primer on this week’s conference in Washington and a look at how the HIV/AIDS fight in the District of Columbia itself compares with a nation in sub-Saharan Africa on three fronts: assisting orphans, preventing the spread of HIV in correctional facilities and reducing stigma in churches.