The article, provocatively titled, “The Challenge of a Cure for HIV Infection,” is authored by three academics, Doug Richman, UCSD; David Margolis, UNC; Warner Greene, UCSF; one community advocate, the late Martin Delaney, Project Inform; and two industry scientist leaders Daria Hazuda, Merck; Roger Pomerantz, Tibotec.
This diverse group came together to set a goal for the next era in HIV therapeutics – drug free remission – and assemble a coordinated initiative to identify potential interventions and a clinical assessment to reach this goal. The initiative, which the authors coined a “collaboratory,” aims to accelerate the progress of individual research groups, harness the drug discovery capabilities of industry and utilize the government to coordinate regulatory approaches and mobilize funding.
“A successful vaccine or microbicide still remains a significant challenge in spite of billions of dollars and years of research, and having millions of people on lifelong highly active antiretroviral therapy (HAART) may not be sustainable,” said Roger Pomerantz, M.D., FACP, President of Tibotec R&D. “At Tibotec, we have a heritage of partnership and collaboration, and we are committed to forging new approaches with others to develop HIV therapeutics that could finally eradicate the disease.”
Envisioning the Post-HAART Era
Since the arrival of HAART more than a decade ago, people diagnosed with HIV have gained a lengthened life expectancy and improved quality of life. Today, patients newly infected with HIV can expect to live 40-50 years as a result of HAART. However, HAART is not the optimal solution for HIV – it requires lifelong therapy, the medication can cause various side effects and the effects of long-term HAART are not yet known. And, if HAART is interrupted, the virus rapidly replicates and the patients’ immune system is attacked once more. HAART suppresses the virus, but it is unable to eradicate it completely. As a result, the virus persists in latently infected cells (HIV latency) and other reservoirs. The authors conclude that eradicating the virus from these cells and reservoirs is a crucial approach in the pursuit for therapies that could provide drug free remission and potentially, a cure.
The three academics and two industry scientists who authored the Science article have individually been involved in independent studies of HIV latency and reservoirs, and there has been significant progress in understanding these conditions. However, the authors point out, such discrete studies may be duplicative and slow to build up a complete picture.
“A flexible, collaborative private-public joint venture has the possibility to catalyze progress in the search for therapeutic interventions that can eradicate HIV and result in drug-free remission for HIV patients,” said Paul Stoffels, M.D., Company Group Chairman, Johnson & Johnson. “This new approach of ‘open innovation’ is critical if we are to meet the really big challenges that remain today in the HIV field, such as eradication.”
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