Renew the push for a cure on World AIDS Day

Who would have thought back in 1984, when Health and Human
Services Secretary Margaret Heckler announced HIV as the probable
cause of AIDS and that a vaccine should be ready in two years, we
would be still working on a cure?
Researchers have created effective drug therapies that have
allowed many of those infected to live relatively normal lives, but
the elusive virus is still winning the war.
Who would have thought back in 1984, when Health and Human Services Secretary Margaret Heckler announced HIV as the probable cause of AIDS and that a vaccine should be ready in two years, we would be still working on a cure?

Researchers have created effective drug therapies that have allowed many of those infected to live relatively normal lives, but the elusive virus is still winning the war.

For the first time in a decade, AIDS is on the rise. Earlier this year, the Centers for Disease Control and Prevention reported a 2.2 percent increase in the number of new AIDS cases in 2002 over 2001. According to the California Department of Health Services, California has reported more than 130,000 AIDS cases and almost 79,000 deaths since the start of the epidemic. World AIDS Day, Dec. 1, serves as a reminder that we must continue our efforts toward finding a cure for AIDS.

A concerted effort is more critical than ever, as AIDS and HIV have become a global concern. Entire generations are being wiped out and new generations are growing up without parents. Finding a cure is an urgent necessity.

AIDS and HIV affect us all in a variety of ways. The human toll is greatest, with so many young people dying before realizing their full potential. The public funds earmarked to fight the scourge are also a huge burden on financially strapped governments. Further, the fear created by the disease shows its ugly head in discrimination and avoidance of people infected.

The general perception that the federal government fully funds AIDS research through agencies such as the National Institute of Health (NIH) is only partly true. Before research teams can receive government funds, new drugs, therapies and vaccines must show some promise of safety and efficacy. This requires research that can only be funded by private individuals, foundations and organizations.

Grassroots fund raising and private donors play a crucial role by providing the seed money needed to launch pilot studies. Health plans contribute through their foundations, having seen their HIV-infected members benefit from guaranteed access to all FDA-approved AIDS drugs, coordinated care and, in California, access to HIV specialists. In addition, other organizations that contribute to prevention and services for those infected can bolster their efforts by adding a third area to their giving – research.

A case in point is the success this year with a new two-step technique, developed at the UCLA AIDS Institute in collaboration with scientists at the NIH, that involves “flushing out” hibernating HIV from its hiding places in the body. This work, led by Drs. David Brooks and Jerome Zack, and funded to a great extent by private foundations, was reported in the September issue of “Immunity.” The report described the killing of HIV virus sequestered in latently infected T cells – a place where it previously could not be detected and killed by antiretroviral drugs. More important, the novel antibody-derived immunotoxin used to kill the virus does not attack healthy cells, only those infected with the HIV virus. In laboratory testing, this approach cleared out nearly 80 percent of the hibernating virus, a rate that has never been achieved in this type of study before.

While this approach still needs to be tested in patients, it has the potential to decrease the levels of HIV in the body, which could help people who are HIV-positive reduce their medications and lead longer, more symptom-free lives.

Developing new avenues for treatment is important to ensure the survival rate and quality of life of people infected with the HIV virus; however, efforts to find a cure require help from drug companies, research institutes, health plans, AIDS organizations and individuals.

The early needs of research programs can only be met through donations from the community. We call on everyone to renew the push for a cure. HIV and AIDS have been with us for more than 20 years. Let’s make this decade the last and final one.

Dr. Jerome Zack is an UCLA AIDS Institute researcher and Dr. Sam Ho is the PacifiCare chief medical officer.

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