Failure to Prevent AIDS Infections Spurs Renewed Hunt for Cure

How scientists might rid latent HIV from the body's cells is one of the topics being presented at the 16th Conference on Retroviruses and Opportunistic Infections this week in Montreal. Last year, the National Institutes of Health asked scientists to detail how they might approach solving the problem, particularly after Merck & Co.'s Ad5 vaccine was found ineffective.

"If the vaccine had worked, I don't think any of this would be happening," said Dr. David Margolis, an HIV researcher at the University of North Carolina—Chapel Hill. "Getting so close to an effective vaccine and then having to start from scratch again has made people wisely step back and re-evaluate the whole playing field of options."

"It's very easy to get the number of viruses circulating in the system down to an undetectable level," said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases. "However, to knock it out, we'll either have to get true eradication, or get the reservoir of virus that's inside cells so low that it can't come back."

If the amount of latent virus could be decreased, the body's immune system might be able to fight the infection without drugs. Fauci referred to that as a "functional cure," which is similar to remissions experienced by cancer patients who have been through treatment.

Myron Cohen, director of the University of North Carolina's Center for Global Health and Infectious Diseases, said the estimated cost for taking lifelong antiretroviral medications is more than $600,000. "Can we sustain this spending for 50 years?" Cohen asked. "We can't treat our way out of the epidemic. Cure of HIV is an idea whose time has come."

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