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Why A Vaccine, Not A Cure?
Sep 24, 2009

Greeting from Australia, Doctors!

Waking up here this morning to the encouraging news that the recent trial involving 16,000 people in Thailand showed 31% at reduced risk of HIV infection after completeing the trial.

Certainly some encouraging news, and something to work on!

However, all I read about is the search for finding a VACCINE!!

Why does there seem to be a lack of searching for a CURE for people like me that already have HIV? :-( And why do we not hear so much about new drugs that are in the pipeline?

Does a cure have to follow-on from a vaccine? Scientifically, is this how it has to work?

Any light you can shed on the subject would be interesting reading!

It is great to hear that hopefully in the (near-ish) future people will be able to protect themselves from getting HIV in the first place, but what about trying to eradicate it from us poor folks who already have it? Are we the "forgotten minority?"

Thanks so much for the work that you do here!

Australian Guy.

Response from Dr. McGowan

Dear Australian Guy.

Yes, the vaccine news is well overdue. Although it is a modest success hopefully it is a start, and any tool to slow down the epidemic is welcome.

There is great interest in a "cure" as well. A vaccine strategy would not necessarily lead to a cure, but there is hope that a vaccine may be developed that could boost the immune system so that it could contain the virus on its own without needing meds. That would not be a "cure" but it could help people live with the virus better.

A cure is difficult because it means getting at the residual virus that is left in the body after medication has supppressed its growth. That "virus" is essentially present as genetic code that sits inside the chromosomes of T cells waiting to be copied and make new virus particles. Research is ongoing to find the signals that control this copying (called transcription) process and which genes are responsible. If we can turn on and off the transcription of HIV genes than we can shut it down. Another strategy is to find medication that will target only cells that have the HIV genes in them. Some novel treatments with medications like depakote (divalproex) have been conducted and may be a model for further research.

The first step is to have your virus suppressed on meds so you will be ready for the next steps, which I do believe will come.

Best, Joe



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