America’s pharmaceutical research and biotechnology companies are testing 97 medicines and vaccines to treat or prevent HIV/AIDS and related conditions, according to a new report released by the Pharmaceutical Research and Manufacturers of America (PhRMA). December 1 marks the 21st anniversary of “World AIDS Day” a global awareness campaign that originated at the 1988 World Summit of Ministers of Health on Programmes for AIDS Prevention.

“We are greatly encouraged by these critically important medicines and vaccines in development to treat and prevent HIV infection,” says PhRMA President and CEO Billy Tauzin. “Pharmaceutical researchers are continuing their efforts to develop new therapies and vaccines to improve and lengthen the lives of HIV-infected patients.”

The report found that the 97 products in development include 23 vaccines and 54 antivirals. These drugs are either in human clinical trials or awaiting approval by the U.S. Food and Drug Administration.

Thirty-one medicines to treat HIV/AIDS have been approved since scientists first identified the virus that causes AIDS more than 20 years ago. The first HIV/AIDS medicine was approved in 1987, just four years after the virus was identified.

Although the U.S. Centers for Disease Control and Prevention (CDC) estimate that more than 1 million Americans were living with HIV infection at the end of 2006, the increased availability and utilization of newer prescription medicines has helped to reduce the U.S. death rate from AIDS substantially in recent years, according to government statistics. In fact, the CDC estimates that since the introduction of highly active anti-retroviral therapy in 1995, the annual number of deaths in the U.S. due to AIDS has dropped by more than 70 percent.

Despite this progress, AIDS remains a devastating and growing health problem in developing countries, particularly in sub-Saharan Africa, China, India and the Russian Federation. According to the Joint United Nations Programme on HIV/AIDS, in 2007 an estimated 33 million people were living with HIV, 2.7 million were newly infected with HIV, and 2 million people died from the disease.

From 2000 to 2007, America’s pharmaceutical research and biotechnology companies contributed more than $9.2 billion to improve health care in the developing world, according to the International Federation of Pharmaceutical Manufacturers & Associations.

The projects they supported included clinics to treat patients with HIV/AIDS, education and prevention programs, initiatives to prevent mother-to-child transmission of HIV, and donations of medicines for AIDS and related diseases. A number of companies also provide AIDS drugs at reduced prices in many countries.

“As a result of HIV/AIDS medicines, a disease that was once a virtual death sentence can now be controlled and treated as if it were a chronic disease,” states Tauzin. “And the new medicines our scientists are working on right now bring hope for even more promising results in the future.”

“While researchers are making exciting progress in the search for new treatments for HIV/AIDS, these efforts are wasted if the medicines that are developed don’t get to the patients who need them,” says PhRMA Senior Vice President Ken Johnson.

An innovative treatment for HIV patients developed by McGill University Health Centre researchers has passed its first clinical trial with flying colours. The new approach is an immunotherapy customized for each individual patient, and was developed by Dr. J-P. Routy from the Research Institute of the MUHC in collaboration with Dr. R. Sékaly from the Université de Montréal. “This is a vaccine made for the individual patient – an “haute couture” therapy, instead of an off-the-rack treatment” said Dr Routy.

By “priming” the immune system, as with a vaccine, to fight the specific strain of HIV/AIDS infecting a given patient, the scientists believe they have developed a therapy that shows immense promise and could be an even more effective weapon against the virus than the anti-retroviral cocktails currently in use. The results of the first-stage clinical trials, which tested the therapy in conjunction with anti-retroviral drugs, were published recently in Clinical Immunology. Phase 2 of the clinical trial, which is nearly complete, is testing the therapy’s efficacy on its own at 8 different sites in Canada.

The new therapy uses dendritic cells which are removed from each HIV-infected patient and subsequently multiplied in-vitro. Dendritic cells present material from invading viruses on their surface, allowing the rest of the immune system to identify and attack the invaders. “They are the “grand conductors” of the immune response,” explains Dr Routy. “With them, you push the immune system, in all its functions, at the same time.” In the current trial, dendritic cells were exposed to a sample of HIV RNA (ribonucleic acid) specific to the patient involved. This exposure encouraged the cells to develop defences specific to that viral strain. The modified cells – called AGS-004 – were then injected back into the patients.

Not only were there few reported side-effects from the AGS-004, but the researchers also measured increased levels of CD8-lymphocytes in the patients – the “attack” cells of the human immune system that the treatment is intended to mobilize, thus confirming that the intervention was targeted and controlled.

By boosting the immune system in this way, Routy hopes to develop an HIV/AIDS treatment that will require fewer injections and less long-term toxicity for patients than antriretrovirals.

Dr. Jean-Pierre Routy is a practitioner in the Division of Hematology at the MUHC as well as a researcher in the Infection and Immunity Axis at the Research Institute of the MUHC.

The Guardian examines the challenge of testing and treating some of the estimated 1.4 million people living with HIV/AIDS in Kenya. “Deep-rooted stigma and patchy health education has led many to cower from the disease, which has seen the country’s life expectancy rates shortened by 20 years in the last two decades,” the newspaper writes. Even though “[t]he country’s government has supplied antiretroviral therapy (ART) to suppress the virus to patients for free since 2006, … of the 390,000 adults estimated as being eligible for ART at the time of the survey, around 140,000, or 35%, were taking the medication,” according to a 2007 country survey.

“Stigma is still the biggest challenge in terms of gaining treatment for people with HIV,” said Charles Maina, Makueni district hospital’s medical superintendent. “People can pay a lot of money for spiritual remedies before seeking medical treatment. They only come to hospital when they are not able to recover – by that stage their conditions can be very complicated.”

The article also examines views of the idea of “treating all HIV/Aids patients with ART could halt transmission of the disease” – explored earlier this month in a World Health Organization consultation – and how it might play out in Kenya (Taylor, 11/23).

In an effort to uncover the riddle that is AIDS-HIV, a team of Amearican and Canadian researchers may have discovered the hiding places for the virus. It seems that it has been lurking in immune cells, allowing the virus to elude current drug treatments. With the new data, scientists may have new leads for innovative treatments for AIDS-HIV.

The American and Canadian researchers with Oregon State University’s Vaccine and Gene Therapy Institute (VGTI) of Florida and the University of Montreal, have found what they believe is a more effective treatment and potentially even cure for AIDS-HIV, based on the discovery of the virus’ hiding places. They have determined using a combination approach of targeted chemotherapy, along with highly active anti-retroviral (HAART) treatments, similar to treatments used to treat leukemia, may not only destroy the viruses circulating within the body, but may also destroy those hiding in the body’s immune system’s cells.

According to study co-leader Dr. Rafick-Pierre Sekaly, “You have to target not the virus, but the cells in which the virus is hiding. And that I think it is a very different concept than what everybody has been pushing for. That clearly is a major finding that we have got to the table.” He added, “This would make it possible to destroy cells containing a virus while giving the immune system time to regenerate with healthy cells.”

Researchers for the newly released study honed in on T-cells or immune cells for their research. T-cells respond to viruses based on vaccines the body has received. If a virus enters the body when a person has already been vaccinated against that particular virus then T-cells launch a very direct attack. However, the T-cells also seem to be the perfect place for HIV to hide out. Dr. Jean-Pierre Routy, an infection and immunity researcher at the Research Institute of the McGill University Health Centre in Montreal and a co-leader of the study said, “For the first time, this study proves that the HIV reservoirs are not due to a lack of potency of the antiretroviral drugs but to the virus hiding inside two different types of long-life CD4 memory immune cells.”

Research for more innovative treatments and cures for AIDS-HIV continue. Currently, drugs developed to treat the conditions have been able to keep AIDS-HIV to very low levels within the body, but they haven’t been able to eliminate the virus completely. Now, scientists have found their hiding places. A study to test the validity of the newly released study will start in September of this year. Dr. Sekaly says, he is “very optimistic” that researchers will be able to develop new drugs to target the hiding spots identified with their new research.

The study can be found online in the journal Nature Medicine.

Although HIV was first identified in 1983, the last twenty-six years have been devoted to finding a cure and helping to make a vaccine for this devastating disease. Every year community groups, city governments, and outreach programs among many others try to spread the word about HIV vaccines. Although science has yet to provide one for this very serious disease, they hope to be close to finding one soon.

Education is the most important part of this awareness day as more people become educated about the dangers of HIV and how to prevent it, the less people become infected and the epidemic worldwide is lowered. With recent news of HIV death tolls skyrocketing in China and the potential promise of a gel that protects women from HIV, it is time now more than ever to promote HIV prevention and hope for a cure.

More and more clinical trials (involving over 25,000 HIV-negative volunteers) are starting in order to get closer to the vaccination that will eventually save millions of lives. This HIV Vaccine Awareness Day, May 18, please make sure your local community and health organizations have all the information they need to help spread the word.

Besides spreading the communal word on Monday, HIV Vaccine Awareness Day (HVAD) is also a day to pause and thank the thousands of people who spread awareness everyday with their efforts against HIV. From volunteers to doctors to researchers and scientists, everyone aiding in the efforts to find a vaccine should be honored today as well. This day is a big “Thank You” to each and every one of them.

All sorts of events are going on in celebration of the 12th annual HVAD all across the United States; go to the HVAD website to join one in your area. Twelve cities around America are participating in preventative HIV trials right now, to be part of one in Atlanta, Birmingham, Boston, Chicago, Nashville, New York, Philadelphia, Rochester, San Francisco, San Juan, Seattle and Washington go to the “Be the Generation” website http://bethegeneration.nih.gov/index.cfm funded by the National Institutes of Health.

With over 40 million people worldwide living with HIV, the National Institute of Allergy and Infectious Diseases has sponsored the initiative to educate people about the importance of preventative measures against HIV, especially focusing on the clinical trials needed to find a vaccine.

For over 25 years we have been plagued by the pandemic that is HIV, helping it to spread rapidly between communities and the repercussions are just now catching up with us because of the incurable nature of the disease. Make sure you educate yourself now and find out how you can help stop the spread of HIV.
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The ancestors of the simian immunodeficiency viruses (SIVs) that jumped from chimpanzees and monkeys, and ignited the HIV/AIDS pandemic in humans, have been dated to just a few centuries ago. These ages are substantially younger than previous estimates, according to a new study from The University of Arizona in Tucson, published May 1st in the open-access journal PLoS Computational Biology.

SIV has crossed over from chimpanzees and sooty mangabeys to humans at least eleven times, giving rise to several HIV lineages. Although HIV is a virulent pathogen in humans, SIV rarely causes disease in these species or the dozens of other African primate species it naturally infects. That these non-human primates typically remain unaffected after virus exposure has led to the hypothesis that there had been millions of years of coevolution between SIVs and their primate hosts.

The researchers, Joel Wertheim and Dr. Michael Worobey, estimated a rate of virus evolution using viral genetic sequences that had been isolated from infected humans, chimpanzees, and sooty mangabeys between 1975 and 2005. They inferred that the viruses currently circulating in sooty mangabeys and in chimpanzees evolved from ancestors dating to 1809 (1729-1875) and 1492 (1266-1685), respectively. Surprisingly, the independently estimated ‘molecular clock’ of the monkey viruses was virtually identical to the famously swift rate at which mutations accumulate in HIV genomes.

The authors note that unaccounted-for biases could be masking a deeper age of SIV. They suggest that if these biases do exist, their causes need to be investigated because they might also affect the ability to properly estimate the age of HIV and other viruses.