It feels like HIV is something we don’t hear the media talking about much anymore. That may be because since the approval of anti-retroviral therapy in 1996, we’ve become really good at treating it. Of course since then, therapy has continued to get better. As of right now, there are five “one-pill-once -a-day” treatment options for HIV and a few more are expected in the next few years. Today we expect someone with HIV who takes their medications regularly to live a normal lifespan and never develop AIDS.
Anti-retroviral drugs work by keeping the HIV virus from replicating and spreading in the blood. The medicines work so well that we expect someone who’s been on them for a few months to have no detectable virus in their blood at all. For example, when Charlie Sheen was diagnosed with HIV four years ago, he had 4.4 million copies of the virus per ml of blood. Within about six months of treatment however, his viral load had become undetectable by the most sensitive tests available. According to the research done to date, when someone has an undetectable viral load it is very unlikely that they can transmit the virus—which is good news—we still recommend using condoms though. The bad news is that it is estimated that of all of the people in the United States with HIV, only about 30 percent of them have an undetectable viral load. The main reasons for this is that many of these people do not know that they have HIV and for the one’s who know their HIV status they aren’t in care. If we could get everyone to get tested, to know their HIV status, and for the ones with HIV onto therapy so that they had an undetectable viral load, we could stop the spread of HIV and potentially eradicate it. It is also important for people who are HIV negative but may still engage in risky behaviors that put them at risk of getting HIV consider starting antiretroviral medication known as PrEP (pre-exposure prophylaxis) that reduces their risk of acquiring HIV in the first place.
Now having an undetectable viral load doesn’t mean that someone is cured of HIV. If someone with HIV stops taking their meds, within a matter of days to months they will see their viral load once again climb. This not only means that they become infectious, but also that they are at risk for complications. The reason that just taking anti-retroviral medications doesn’t cure HIV is because the virus incorporates itself into the persons DNA and hides out in hibernating cells. When anti-retroviral therapy is stopped the virus wakes these cells up and starts reproducing itself.
As you heard on today’s show, Charlie Sheen is on a hunt for a cure for HIV and he is not alone. In fact scientists all over the world are working on the HIV “Cure Agenda.” The AIDS Clinical Trials Group funded by the NIH has the Cure Agenda as one of its main initiatives and the foundation for AIDS research amfAR even recently started the Institute for Cure Research at UCSF.
As part of his own hunt for the cure, Charlie and our cameras recently visited the Scripps Research Institute in La Jolla California. This is one of the country’s pre-eminent research universities and faculty there is working in collaboration with other researchers around the country to develop an HIV vaccine.
Now you might ask, what does a vaccine have to do with finding a cure-wouldn’t a vaccine be for prevention? You would be right–the idea of a vaccine is to get the body to make antibodies that would prevent someone from getting an infection in the first place. A successful vaccine would be helpful again in helping us eradicate the disease. Also though, the right vaccine could potentially keep someone who is infected with the virus from having it replicate. This would mean that someone could maintain an undetectable viral load without meds. There have been many trials for HIV vaccines, but the upcoming Scripps vaccine may be the most promising yet. You can read more about it here.
We’ll continue to follow Charlie on his search and invite you to join us.