WEDNESDAY, 19 NOVEMBER, 2003
Hopes for a cure crushed - KHORRAM COUNTRY - THE COMMENTARY
By Babak Khorram
Few diseases have plagued humankind the way AIDS (Acquired Immune Deficiency Syndrome) has. The virus that causes AIDS, Human Immunodeficiency Virus (HIV) has gone from being a sporadic pathogen to the cause of a worldwide pandemic. An estimated 42 million people around the world are living with HIV. More than two-thirds of them live in Sub-Saharan Africa, where in the hardest hit countries one in every three adults has the disease. HIV and AIDS are, however, not specific to Africa. The disease has spread throughout other regions, most notably South and South East Asia.
The Human Immunodeficiency Virus is extraordinarily lethal for several reasons. First, unlike most viruses, it has a very unique target in the human body. It does not attack the liver in the same manner hepatitis does or the respiratory tract in the same manner influenza does. Instead, HIV targets the immune system by attacking what are known as T-cells. T-cells help target and destroy cells infected by pathogens, such as bacteria and viruses. By attacking the immune system, the virus ensures the destruction of the entity that intends to destroy it. Moreover, the virus can be carried for months if not years before the human host displays any of the symptoms specific to AIDS. This way, a person with HIV may appear to be healthy and can spread the disease to others unknowingly. Last, and perhaps most significantly, HIV mutates readily and rapidly. Therefore drugs and vaccines that may have been effective against the virus several years ago are now highly ineffective.
At least 28 million people worldwide have died from AIDS - their bodies' defense systems ravaged by the HIV virus to the point where everyday infections become life threatening. More than 20 years since HIV was first recognized, there is no vaccine against HIV and no cure for AIDS, although a new generation of drugs has dramatically extended the life expectancy of those who contract HIV.
Recently, there has been new hope in the fight against AIDS. The biopharmaceutical company VaxGen has developed a vaccine against HIV, termed AIDSVAX. The vaccine is in the third phase of clinical trials. Basically, it is being administered to volunteers in certain places to test its effectiveness and efficacy.
The test for AIDSVAX took place in Bangkok, Thailand. Thailand once had a soaring HIV infection rate, but has since taken major steps to reduce the spread of the virus. So far, they have succeeded in reducing the HIV infection rate but AIDS still remains a major health and social issue. The test involved more than 2,500 injecting drug users in Bangkok. Of those involved in the test, half were given the actual vaccine and half were given a placebo. The vaccine did not actually contain any genetic material from the virus, but instead contained synthetic versions of proteins found in the virus. The idea was that the immune system would become sensitized to these proteins, and launch attacks on any virus, which contained them. Thereby, destroying HIV immediately after it encounters its human host.
During the trial, 105 volunteers given the placebo became infected by HIV, compared with 106 vaccinated volunteers. The results showed that those given the vaccine had the same likelihood of being infected by HIV than those that were not vaccinated. In fact, HIV infected the same number of people given the vaccine than people given the placebo. The rigorous make-up of the trial means that the results are likely to be reliable, and the attention of researchers is now likely to turn towards other HIV vaccine projects currently underway in Africa and elsewhere. A number of potential vaccines are at an advanced stage of testing, although final results will not be available for some time. These results are extremely disappointing and disheartening, especially to those millions that are already suffering from this dreaded disease. Many in the medical and scientific communities felt that AIDSVAX was the first legitimate hope for a vaccine against HIV. A vaccine that prevents HIV infection can, in essence, prevent AIDS. These results were discussed by VaxGen president and co-founder Dr. Donald Francis, "The outcome of this trial is one more reminder of how difficult it is to combat HIV and how important it is for the international public health community to redouble the effort to develop an effective vaccine."
Now the underlying question becomes, what must be done until a vaccine against HIV can be developed? The world must move to stop the spread of AIDS. In countries, such as those in Africa, cheaper drugs are merely short-term solutions to a long-term problem. The cheaper drugs must be accompanied with programs that re-educate. In some parts of Africa, it is believed that man with AIDS can "cure" himself by having sex with a virgin. The peoples of the world need to be taught to take measures to protect themselves and those around them. In regards to those affected by HIV and AIDS, people must treat them with compassion and ensure that their communities do not stigmatize them. Only together can the world combat this lethal virus, until a safe and effective vaccine can be developed as a final solution.
You may reach Babak Khorram at bkhorram@thecommentary.ca
Mr. Khorram will return in three weeks.