Progress on AIDS Treatment

[+ Lucky]

Good news from the French as World AIDS Day approaches. A custom made vaccine may be somewhere on the horizon:

 

French vaccine fuels hope in AIDS treatment

Preliminary study shows promise in suppressing virus

Sabin Russell, SF Chronicle Medical Writer

 

Monday, November 29, 2004

 

 

French researchers reported Sunday that an AIDS vaccine designed to treat the disease, rather than prevent it, has scored an initial success by suppressing the virus for up to a year among a small group of patients who tried it.

 

Although the technique is cumbersome and costly, the experiment published in an online version of the British journal Nature Medicine is being touted as "the first demonstration of an efficient therapeutic vaccine against AIDS."

 

The vaccine was tested in Brazil on 18 volunteers who were already infected with HIV, the virus that causes AIDS, but who were not yet taking any antiviral drugs. After four months, the level of HIV in their bloodstreams had been reduced an average of 80 percent.

 

By the end of one year, eight patients in the group had maintained a 90 percent reduction in virus particles in their bloodstream. Four of those patients had virus levels so low that they were comparable to so-called "long- term non-progressors," a rare cohort of people infected with HIV who never seem to get sick.

 

Unlike a conventional vaccine, this one cannot block infection from occurring. However, if the French technique could be perfected, it has the potential to keep some HIV-infected patients healthy without their having to take the three-drug "cocktails" of toxic antiviral drugs.

 

Instead, a series of injections, perhaps once a year, would keep their chronic infections in check.

 

The lead investigators in the French study are Drs. Jean-Marie Andrieu and Wei Lu of the Institute of Research for Vaccines and Immunotherapies for Cancer and AIDS, in Paris.

 

In an interview, Andrieu estimated that the cost of the annual therapy could be $4,000 to $8,000, less than a year's course of antiviral drugs. He said the only side effect of the therapy was a swelling of the lymph nodes, which caused no pain. The swelling was, in fact, an indicator that the vaccine was marshalling the body's immune system properly to ward off the AIDS virus.

 

No new patients have been enrolled in the experiment, but Andrieu said future research will attempt to understand "why it works in some people, and not in others.''

 

Although the experiment falls short of a breakthrough against AIDS, it represents a rare piece of good news in the field of vaccine research, which has been marked in recent years by a string of setbacks.

 

UCSF doctor sees cause for hope

 

"This is just a preliminary study, but it is encouraging,'' said virologist Dr. Jay Levy of the UCSF AIDS Research Institute. Levy did not participate in the research but is familiar with its findings.

 

Further studies are needed, Levy said, to learn exactly why the vaccine worked better than other, similar versions. A critically important step would be to determine whether the vaccine also reduced the amount of virus in sexual fluids. If it did so, a population of HIV infected individuals treated with the therapeutic vaccine would be less likely to transmit the virus to others. "The purpose of a real vaccine is to protect a population. This would have that advantage,'' Levy said.

 

At present, however, the vaccine is difficult to produce, and impractical to deliver to large numbers of people. This therapeutic vaccine is essentially custom-made for each patient who takes it.

 

To make a dose of vaccine, the French doctors extract from each HIV- infected patient a sample of dendritic cells -- starfish-shaped white blood cells that play a special role in the human immune system. They also take a sample of the virus from the infected blood of each patient.

 

In the laboratory, they separately grow uninfected dendritic cells and a batch of the virus itself. The virus is eventually killed and mixed in with the dendritic cells, whose special function then becomes vital.

 

The dendritic cells consume the virus, breaking it into pieces and displaying the parts on their surfaces like grisly trophies.

 

Doctors then inject the dendritic cells back into each patient.

 

Lymph nodes receive the message

 

Inside the body, the dendritic cells migrate to the lymph nodes, carrying their message of an invading microbe to resting banks of "killer" white blood cells. The broken bits of HIV on the dendritic cell's surface help to program these killer cells to recognize the virus -- like bloodhounds given a scent to chase. Once activated, they will seek out and destroy any cell in the human body that is infected by HIV.

 

It is a system of "cellular immunity" that the body routinely uses to protect itself. The AIDS virus, for reasons not fully understood, has managed to hijack the process. Dendritic cells are, in fact, one of the favored targets of living HIV, and once it ferries HIV to the lymph nodes, it then infects other white blood cells, making more copies of itself, and eventually depleting the cells.

 

The French laboratory intervention, by mixing dendritic cells outside the body with killed HIV, seems to restore their proper defensive role when they are returned to the body.

 

It is this focus on dendritic cells, and the use of a whole, killed virus, that distinguishes the French effort from other attempts to make a therapeutic vaccine.

 

Any optimism about the French experiment must be tempered with caution. The history of AIDS vaccine research is littered with failure. An attempt by British and Kenyan scientists to use this concept of cellular immunity to make a preventive vaccine was abandoned in August after a trial in Nairobi showed it did not stir up a strong enough response to protect against HIV.

 

Laboratory experiments with a similar vaccine that showed great promise in monkeys have slowed after further studies showed the virus was able to mutate into a vaccine-resistant strain.

 

E-mail Sabin Russell at [email protected].

[+ Charlie]

The Bush administration will probably ignore it because the scientists are French.

[Knabegeil]

No, the French will probably prevent any exportation of this technology to the US unless we say, "Please." Ooops. I meant, "S'il vous plait."

[noviceny]

Im not sure I understand. If the vaccination is specific to each client, then that means the client already has the virus right ? If so, then how would the vaccine work ? Arent vaccines preventative ?

[guptasa1]

I could be totally off base, but maybe the vaccine prevents AIDS but NOT HIV? In other words, you only get it once you already have HIV, but the hope is it will never develop into AIDS? (This is all pure speculation on my part.)

[+ Lucky]

RE: World AIDS Day

 

So many memories of guys who didn't make it through to the cocktail stage; so many worries about the guys who are at risk now in the tina stage.

[noviceny]

RE: World AIDS Day

 

Gup,

 

Wow...I never thought of it that way...maybe you are right.

 

 

Lucky,

 

I was too young to have friends with AIDS in the beginning of the epidemic, but my uncle died from it in 1990. I remember that heroin was the big, fucked up drug back then for transmission. Such a shame that Tina has now taken over such a huge part of people's lives

[+ Lucky]

Antiviral drug used to treat AIDS to be tested as vaccine

Sabin Russell, Chronicle Medical Writer

 

Wednesday, December 1, 2004

 

 

The theory that an antiviral drug used to treat AIDS may also be used to prevent it will be put to the test in San Francisco and Atlanta this month, when enrollment of 400 gay men will begin for the U.S. arm of an international HIV prevention study.

 

The drug in question is tenofovir, sold under the trade name Viread by Gilead Sciences of Foster City. Since its approval by the Food and Drug Administration in 2001, it has become by some measures the most widely prescribed AIDS drug in the United States.

 

Because the drug is deemed the least toxic of available AIDS medications and is taken just once a day, researchers have been eager to test it as an HIV prevention pill. Scientists hope that the same antiviral qualities that allow the drug to suppress HIV in infected patients would stop the virus from taking hold in a healthy person exposed to it.

 

"There are 150,000 HIV-infected people who have been on tenofovir, and the safety profile looks very good," said Dr. Lynn Paxton, who is coordinating the American and overseas studies for the Centers for Disease Control and Prevention in Atlanta. "We want to look at it, to see if it is safe for HIV- negative people.''

 

San Francisco health officials highlighted the city's participation in the international prevention studies Tuesday in advance of today's observances of World AIDS Day, an effort to draw attention to the epidemic now afflicting 39 million people around the globe.

 

The study's structure is similar to clinical trials of AIDS vaccines, and as in vaccine trials, researchers must weave through an ethical minefield to be certain that participants are fully educated about the risks involved.

 

The Atlanta and San Francisco research is designed to answer two questions: Is the drug safe to use for prevention among gay men? And would using it cause an increase in unsafe sexual behavior that could actually raise infection rates?

 

Two hundred gay men in each city will be selected for the study, which will require them to take a pill every day for two years. Half will be assigned tenofovir, while the others will be given a dummy pill, or placebo. None of the participants will know whether they are taking the real drug or not. At the end of the study, researchers -- who also do not know which patients are assigned tenofovir -- will compare the results.

 

Because the American trials are relatively small, there will not be enough information developed in two years to answer whether or not taking tenofovir prevents HIV infection. It will take the larger, overseas studies to find that out.

 

A proposed trial of tenofovir among prostitutes in Cambodia, designed by UCSF researchers and to be funded by the Bill & Melinda Gates Foundation, was scrapped this summer after that nation's prime minister objected to the study's design.

 

In April, however, a similar trial was launched without incident in the African countries of Nigeria, Cameroon and Ghana.

 

And in addition to its U.S. experiment, the CDC is launching large trials of tenofovir among HIV-negative volunteers in Botswana and Thailand.

 

"These trials first got started among heterosexuals in the developing world, because (heterosexual sex) is what's driving the worldwide epidemic,'' Paxton said.

 

In CDC-sponsored trials in Botswana, where nearly 40 percent of adults are HIV positive, 1,200 uninfected men and women ages 18 to 29 living in the two largest cities of Gabarone and Francistown will be enrolled. In Bangkok, CDC-backed researchers are enrolling 1,600 intravenous drug users who are HIV negative.

 

One dilemma facing researchers is that the only way to prove an AIDS vaccine or preventive drug works is to show that those given a placebo have a higher infection rate than those taking the drug. But ethics and trial rules require researchers to do everything they can to dissuade all participants from engaging in the risky sexual behavior that could ultimately prove the drug's effectiveness.

 

Participants will be repeatedly counseled on safer sexual practices, such as condom use, and will be warned that there is no way they can know if they are given an active medication or a dummy pill and that even if they do get the drug, it may not protect them.

 

Dr. Susan Buchbinder, director of HIV research for the San Francisco Department of Public Health, said ideally 100 percent of participants given HIV prevention counseling would remain uninfected, proving that AIDS can be stopped by education alone. However, scientists have found that even with counseling, high-risk individuals end up with infection rates of 2 to 4 percent.

 

And should the evidence mount that tenofovir provides some protection against HIV infection, researchers fear it may reduce the incentive of those taking the drug to practice safer sex. The San Francisco and Atlanta trials are designed to detect whether this is happening and, if so, whether it negates any protective effect of the pills.

 

If some of the American patients taking tenofovir become infected, the study will also tell whether the virus they contracted is resistant to the drug.

 

 

 

--------------------------------------------------------------------------------

To participate

Information about enrolling in San Francisco's tenofovir study, referred to as Project T, as well as in a forthcoming study of an experimental AIDS vaccine developed by Merck & Co., will be posted shortly at http://www.sfaidsresearch.org.

[+ honcho]

>I could be totally off base, but maybe the vaccine prevents

>AIDS but NOT HIV? In other words, you only get it once you

>already have HIV, but the hope is it will never develop into

>AIDS? (This is all pure speculation on my part.)

 

That's exactly the way I read it. The technique being used here is similar some treatments used for cancer. It's tailor made for each individual; if you want to read up on it, google "monoclonal antibodies".

[+ Lucky]

RE:BIG COCK!! CUM EVERYWHERE!

 

Fewer people have looked into my World Aids Day thread on the promising new treatment than have looked at the thread about the Manhunt winner. Is that a reflection on me, hehehe, or is AIDS just something that is not in your world anymore?

[jackhammer91406]

RE:BIG COCK!! CUM EVERYWHERE!

 

>Fewer people have looked ..... Is that a reflection on me, hehehe,

 

Yup, a reflection on you. Course any reflection of you is going to be hot and sexy, so go figure...

 

>AIDS just something that is not in your world anymore?

 

I think the reason I didn't read this thread at first is because it didn't say

BIG COCK!! CUM EVERYWHERE! in the title.

Seriously, I would guess the number of views is impacted by the fact that most people not already infected, don't have much contact or interest in the release of information about treatment. I believe it's in all of our interests of course, that progress continue to be made. But those who don't care and are searching for a bug donor don't likely have an interest in keeping informed since they have already made a decision to ignore the disease.

 

Those of us who have had friends die from AIDS can only be wistful about what might have been if these discoveries had come sooner. That only makes the seeming indifference to research by the government in addition to our own community more incredible.

 

Thanks for sharing the information Lucky.

[+ deej]

RE:BIG COCK!! CUM EVERYWHERE!

 

:7

 

Want us to edit the original thread subject to this more enticing one? }(

[VaHawk]

RE: World AIDS Day

 

>So many memories of guys who didn't make it through to the

>cocktail stage; so many worries about the guys who are at risk

>now in the tina stage.

 

Sorry, I know you don't like people repeating the post they are responding to, but I did so, because I didn't want to lose my train of thought (too many brains cells destroyed, never to return ).

 

Thanks for posting this, as AIDS is still a vital topic of discussion and is, once again, a growing concern in the gay community, and it is a great public service to bring the latest in research to the attention of all of us.

 

IMO, many of the early treatments and even some of the cocktail treatments, hastened the demise of many people who were afflicted with AIDS. One could say, that they were the guinea pigs, and it seems that this new treatment is once again, calling for volunteer test subjects to be the guinea pigs. I can't imagine any HIV person, given today's treatments, volunteering for this trial unless they are the ones where no combination of drugs has proven to be effective.

 

It seems that so many people aren't concerned with the AIDS virus anymore, while there is still no cure for, nor any vaccine to prevent the AIDS infection. I guess they have that attitude "that modern day drugs make the disease manageable". They don't realize that these drugs don't work for everyone, they don't realize how expensive these drugs are, they don't realize that a combination of these drugs may be effective for 2004 but be ineffective for 2005 with the mutation of the disease, such mutation often caused by the very drugs being used.

 

I too have memories, of the many, many, many people in my life who have perished from this disease. If the seriousness of this disease needs a visual context to hit home with anyone, then they should go see the full display of the AIDS quilt, where each panel speaks for just ONE person who has perished. I cannot even begin to describe the emotions, that seeing that display that took up the entire Mall in DC had on me!

[+ Lucky]

RE:BIG COCK!! CUM EVERYWHERE!

 

No,deej, just send the big cock to me and I will cum everywhere!

 

Thanks, jack and hawk for your comments. It does seem to be the case that the current trend is to consider AIDS someone else's problem. How fortunate for those who can, I guess.

[FrancoDiSantisxxx]

HIV 101

 

>>I could be totally off base, but maybe the vaccine prevents

>>AIDS but NOT HIV? In other words, you only get it once you

>>already have HIV, but the hope is it will never develop into

>>AIDS? (This is all pure speculation on my part.)

>

 

It is a "therapeutic vaccine" not a "preventative" vaccine, as most people likely understand them. When you get a flu vaccine shot, you are getting a killed virus injected inside you in order to incite an immune response from your antibodies, which would then prevent the actual virus from giving you the flu in the future. That makes a flu vaccine a PREVENTATIVE therapy. However, vaccines are very complex and problematic. Keeping with my flu example, if the scientist guess wrong and pick the wrong flu virus (which mutates and changes from year to year, as do colds, which is why a human being can get the flu or a cold year after year, but only catches illnesses like the measles once), then the shot was a waste of time and money. This process is what has made a vaccine so difficult and time consuming to find, especially given the complex and highly mutative abilities of the HIV retrovirus.

 

Additionally, there is more money for the drug companies to make medications to try to make someone healthy than to keep them from getting sick. Therefore, most research into a vaccine to prevent HIV infection is done by the government and other researchers, such as universities.

 

The vaccine Lucky posted about, being investigated by the French, is therapeutic in nature, meaning it would keep someone from getting sick and, as Lucky's post pointed out, it would do so with a few injections during a one year period, as opposed to a daily regimen of taking pills several times a day. In this regard, if they are able to recreate the results of this small study with many more individuals in many more studies, this would indeed be a great event.

 

Now, to clear up some of the other confusion. HIV is the virus. The individuals in this French study were infected with HIV. The point of the vaccine was to keep the HIV retrovirus from replicating in their system, once they were infected, in order to keep them from getting sick and to keep their immune system from collapsing. Once an HIV infected individual has an immune system failure, they are said to have progressed to "full-blown" AIDS, which is a syndrome or collections of diseases which affect the individual due to the immunse system collapse.

 

An excellent web site to keep up with current clinical trials, to explain basic information every sexually active gay men should know about HIV and AIDS and to keep up with treatment and other promising results is http://www.aegis.com/

 

It also offers a collection of links which can provide further reading.