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Current Research in HIV/AIDS

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The Pediatric AIDS Coalition Cause Education Committee

Publicada em: Educação
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Current Research in HIV/AIDS

  1. 1. Modern Drug Treatments for HIV: Potential Cures Saskia Leonard and AnnaTong
  2. 2. Why look for a cure? Timothy Ray Brown, also known as the "Berlin patient," was the first person to be cured of HIV infection, more than a decade ago. - HIV is not a death sentence anymore with daily intake of medication - But only 21 million of 37 million people have access to drug therapy - Lower-income countries have lower access to consistent/wide spread treatment - Drug resistant virus
  3. 3. Current Case - Now researchers are reporting a second patient has lived 18 months after stopping HIV treatment without sign of the virus following a stem-cell transplant. - Referred to as “London Patient” - Was suffering from Hodgkins Lymphoma and was infected with HIV - Received bone marrow cells as part of his cancer treatment in 2016 from a donor who had a malfunctioning CCR5 gene, which creates a protein crucial for HIV to invade white blood cells - Key is to shut down the CCR5 gene
  4. 4. Why is this exciting? - Big news for the research community looking at how gene therapy can disable the CCR5 gene by using other technologies including the gene editing technology CRISPR - Proof that HIV is curable - “The hope is that this will eventually lead to a safe, cost-effective and easy strategy to achieve these results using gene technology or antibody techniques.” - Informs broader community- in the news!
  5. 5. Why is it problematic? - Not readily available to do a stem-cell transplant - Can have severe side effects - Stem cell transplants are risky - Donors must be a genetic match to recipients and very few people naturally carry two copies of the disabled CCR5 gene
  6. 6. Genome Editing - A Controversial Case ● Chinese scientist who made the world’s first genome edited twin babies: He Jianuki ○ Impregnated a woman with babies who lacked the gene utilized by HIV to infect cells ○ The editing was successful and only the target gene was edited ● Used CRISPR-Cas9 genome-editing tool to disable CCR5 - protein used by HIV to enter T-cells ● Father HIV-positive
  7. 7. Ethical Implications of Gene Editing ● There are other safe and effective ways to use genetic editing for HIV prevention ○ No unmet medical need that gene editing fulfills ● “Directly jumping into human experiments can only be described as crazy” ● Marginalizes already marginalized groups - very expensive ● Where to draw the line in terms of gene editing ● Incredibly risky- may target other genes inadvertently and may affect other normal functioning ● Some strains of HIV do not even use this protein to enter the cells, but use another called CXCR4
  8. 8. Other advancements in treatment - Conference on Retroviruses and Opportunistic Infections making progress on treatment especially in Africa - Monthly injection of HIV drugs suppress the virus the same amount as daily pills - Good because many people forget to take their pills daily. - Doctors working in impoverished countries are eager for injections or implants that will release small daily doses of antiretroviral drugs because the devices can be used in secrecy. - Providing injections may be harder than handing out pills, but the option may attract patients with H.I.V. who would otherwise stay away because of - Fear and stigma - Contraceptive injections are favorable and more effective because many women have to hide birth control from their partners who might get angry that they don’t want more kids - Gay or bisexual men may want to be discreet, because often hiding from spouses or families that they have sex with men - Truveda , PrEP pill, taken every day are almost 100% protected against getting HIV from unprotected sex or drug injection - $20,000/year and hard to get it to uninsured in the US - Discovy is an alternative to Truveda that is cheaper but more likely to raise cholesterol, which is problematic