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30 Years of AIDS Research

30 Years of AIDS Research

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A June 17, 2011, broadcast from the National Institutes of Health describes the many obstacles doctors still face in treating AIDS 30 years after the first reported case.

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Harvard AIDS Institute: Founded 30 years ago

The year was 1988. People were afraid. A total a 106,994 people had been diagnosed with HIV/AIDS in the U.S. and 62,101 were dead. Scientists were making progress, but there was no effective treatment. One night the evening news would feature protests by AIDS activists demanding faster drug approval. The next night the news featured parents demanding kids with HIV be barred from public schools.

On May 6, 1988, Harvard President Derek Bok announced the establishment of the Harvard AIDS Institute (HAI) to expand and accelerate AIDS research at Harvard. “The conquest of AIDS will require the commitment of experts concentrated at the School of Public Health, the Medical School and its teaching hospitals as well as from many disciplines throughout the University,” said Bok. “The Institute’s mission is to focus our resources and redouble our efforts.”

Bok named Myron “Max” Essex, a virologist at the Harvard School of Public Health (HSPH), to lead the Institute. According to Essex, “HAI was the brainchild of Harvey Fineberg,” who was HSPH Dean at the time.

“I wanted Harvard to declare a clear and compelling commitment to cope with the AIDS epidemic,” remembered Fineberg. “To deal with it not just as an intellectual problem, but as a practical and social problem. Max Essex was the obvious choice to lead the enterprise. He had been at the center of research on retroviruses and what later became HIV/AIDS research.”

After arriving at Harvard in 1972, Essex quickly made his mark. He showed that feline leukemia was caused by a type of infectious disease — a retrovirus — which could also suppress the animal’s immune system. In the early 1980s, when the Centers for Disease Control in Atlanta began investigating deaths in gay men with immunosuppression, Jim Curran, who led the investigation, called Essex for help and sent samples to his lab. Scientists were searching for the cause of what would later be named AIDS.

Essex was one of the first researchers to hypothesize that a retrovirus was the cause of AIDS. Later, he and a graduate student, Tun-Hou Lee, identified gp120, the envelope protein of the virus which became the basis for HIV tests. Essex, graduate student Phyllis Kanki, and their colleagues discovered SIV, an AIDS-like virus in monkeys. They also identified HIV-2 in West Africa, a virus similar to but less lethal than the more common HIV-1.

“It was a time when discoveries were happening almost monthly — major discoveries,” remember Richard Marlink, a young doctor who joined the Essex team. “Tun-Hou Lee and Phyllis Kanki and others were figuring out where the virus came from and how it worked.”

As AIDS took hold in the 1980s, Essex and his team collaborated with other scientists and clinicians in the Boston area, including Martin Hirsch, head of infectious diseases at Massachusetts General Hospital William Haseltine, a molecular biologist at the Dana Farber Cancer Institute and Jerome Groopman, an oncologist studying AIDS-associated cancers at the Deaconess Hospital.

Aids and HIV: 30 years on, millions of lives are being saved

An estimated 6.6 million people with HIV in the developing world are now on drugs to keep them well and stop them developing Aids – a substantial increase since last year – according to the World Health Organisation.

The WHO's announcement came as experts and campaigners commemorated the 30th anniversary of the first diagnoses of Aids. A US medical bulletin revealed on 5 June 1981 that five young, gay men in Los Angeles had a form of pneumonia that normally only appears in people whose immune systems have collapsed. They were the first documented cases of the HIV epidemic that was to sweep the globe.

There are now 33.3 million people globally living with HIV, which was once a death sentence. The roll-out of drugs across the developing world, subsidised by the donors of richer countries, is saving millions of lives.

Latest figures from the WHO show that last year saw a bigger increase in people in poor countries accessing the drugs than ever before – a rise of 1.4 million over the previous year. There has been a 16-fold increase in the numbers on antiretroviral treatment between 2003 and 2010. But 9 million more people in low and middle income countries need the drugs and cannot get them.

"The impressive new estimates are an important milestone in the public health response to HIV that began 30 years ago," said Dr Margaret Chan, WHO director general. "But we have much to do to reach the goal of universal access, and doing more of the same will not get us there. We need further innovation in HIV, including simpler and more accessible prevention and treatment approaches for all those in need."

New hope, but with new challenges, was offered by a trial which recently showed that antiretroviral drugs not only keep people with HIV well but prevent them from passing the infection to their sexual partners. Aids campaigners are now calling for the roll-out of drugs to be stepped up as a way of slowing the epidemic.

"Access to treatment will transform the Aids response in the next decade. We must invest in accelerating access and finding new treatment options," said Michel Sidibé, UNAids executive director. "Antiretroviral therapy is a bigger game-changer than ever before – it not only stops people from dying, but also prevents transmission of HIV to women, men and children."

"Countries must use the best of what science can offer to stop new HIV infections and Aids-related deaths," said UN deputy secretary general Asha-Rose Migiro. "We are at a turning point in the Aids response. The goal towards achieving universal access to HIV prevention, treatment, care and support must become a reality by 2015."

Between 2001 and 2009, the global rate of infections declined by nearly 25%, according to UNAids. That is a result of hard work on prevention and awareness of the infection, with people starting to adopt safer sexual behaviours, limiting their number of partners and using condoms more.

But ahead of a UN general assembly special session meeting on Aids next week, experts warn there is much more to do and real dangers of slipping backwards if money for the battle against HIV starts to dry up. In 2010, funding dropped for the first time.

"I am worried that international investments are falling at a time when the Aids response is delivering results for people," said Sidibé. "If we do not invest now, we will have to pay several times more in the future."

The International Aids Society, whose members are doctors and scientists working on HIV, is calling for more investment not only in care for Aids but to find a cure.

In the US, Anthony Fauci and Jack Whitescarver of the National Institutes of Health, which is the largest funder of HIV research in the world, said a huge amount of progress had been made. They were, however, "sobered by some grim realities and remaining challenges".

Infections are still going up – 2.6 million were newly infected last year – and in developing countries only around a third of those who need drugs are on them.

"In addition, a growing proportion of patients receiving long-term antiretroviral therapy are experiencing treatment failure, drug toxicities, side-effects and drug resistance," they said, and recent studies had shown increasing health problems linked to long-term drug treatment.

Successes, failures mark 30 years of HIV/AIDS research

It is difficult to put your finger on why, almost exactly three decades after the first case of AIDS was reported, there is now a general feeling in the scientific community that big breakthroughs are coming soon in AIDS vaccines, treatments and prevention. It is not only that big financiers like the Bill & Melinda Gates Foundation are contributing millions to the eradication of HIV (although that certainly helps). It's that the 30 years spent on understanding the virus that causes AIDS is at last making sense in a coherent way.

Breakthroughs in genetics, drug delivery, vaccines, computer modeling and other disparate disciplines are all converging onto their target. Even recent vaccine failures have opened up new avenues of inquiry.

"This is a pivotal moment in HIV vaccine research," Alan Bernstein, executive director of the Global HIV Vaccine Enterprise, recently told Reuters. "The last five years have been the richest period in HIV vaccine research since the epidemic began. The question. now is how do we build on these scientific advances?" He added that cross-border and cross-discipline collaboration among scientists was crucial.

Much work still needs to be done to rid the world of this modern-day plague that has cost so many lives, but it seems to be with renewed focus, AIDS research is moving forward. With antiretroviral combination drugs as treatment and possibly prevention, and a reinvigorated vaccine search, it is possible that HIV/AIDS could eventually go the way of smallpox into the dustbin of history.

HIV, the virus that causes AIDS, has a frustrating ability to evolve rapidly. Think of all those science-fiction movies where some sort of out-of-control machine intelligence seems to be defeated at first, then comes back stronger as it adapts to the weapons used against it. That is what HIV does, and how it frustrates and foils those who think they have found a single weapon to use against it.

The answer, then, is that there is no single ultimate weapon that can be used against HIV. And that is where current vaccine research is taking us. The next generation of HIV vaccines are known as "mosaics." They are composed of many sets of synthetic, computer-generated sequences of proteins that can prompt the immune system to respond to a variety of strains. Such vaccines have shown success in animal studies, and new trials will test the mosaic concept and could possibly lead to the next generation of HIV vaccine candidates.

A new consortium, funded in part by the Bill & Melinda Gates Foundation, is trying for a Mosaic vaccine, hoping to launch trials by late 2012.

The one vaccine trial that just about everybody who follows HIV developments references as a success is commonly known as the "Thai Trial." It was a vaccine trial in Thailand known as RV 144 that began in 2003 and ended in 2006, with results released in 2009. Those who received the vaccine saw a 31 percent drop in HIV infection compared to those who received placebo, prompting many to declare RV 144 the first vaccine to give any supporting evidence of having lowered the risk of contracting HIV.

The prime vaccine was ALVAC‐HIV, which consisted of a viral vector of genetically engineered versions of three HIV genes (env, gag and pro). It is manufactured by Sanofi Pasteur. The booster vaccine was manufactured by Genentech under a license and supply agreement with VaxGen.

The approach the trial took is known as "prime boost," which is essentially administration of one type of vaccine followed by a second type. The idea is to enhance the body's immune responses to the virus.

The Thai trial is being studied closely as the model for future development of a final vaccine.

Building on the encouraging results of the Thai trial, Crucell is joining with a host of collaborators to develop a prime-boost combination vaccine. Working with researchers from Harvard University's Beth Israel Deaconess Medical School and the Ragon Institute, the Dutch biotech plans to mix its vaccine with a candidate from the International AIDS Vaccine Initiative in the prime-boost approach. The investigators will track the combination vaccine's safety as well as its ability to provoke an immune response among healthy volunteers.

If the Phase I trial is successful Crucell says they can pursue plans to mount a proof-of-concept Phase IIb study. The research work is supported by the National Institute of Allergy and Infectious Diseases. It might have been Crucell's work on the AIDS vaccine that convinced Johnson & Johnson that it wanted to buy Crucell, in part to boost its own vaccine program. Next page >>

Key goals for building on 30 years of HIV/AIDS research

In the 30 years since the first reported cases of a mysterious illness now known as AIDS, researchers have made extraordinary advances in understanding, treating and preventing the disease. Now the challenge, according to experts at the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, is to build on those successes to control and, ultimately, end the HIV/AIDS pandemic.

In an article published online by the Annals of Internal Medicine, Anthony S. Fauci, M.D., NIAID Director, and Carl W. Dieffenbach, Ph.D., Director of the NIAID Division of AIDS, discuss three research and implementation goals they believe are key to successfully achieving the long-term objective of ending the HIV/AIDS pandemic:

  • Efficiently identify greater numbers of HIV-infected people earlier in the course of their disease through expanded voluntary HIV testing programs, and link them to appropriate care and antiretroviral treatment
  • Find innovative approaches to curing HIV/AIDS by eradicating or permanently suppressing the virus in infected people, thereby eliminating the need for lifelong antiretroviral therapy
  • Scale-up implementation of proven HIV prevention strategies, develop additional effective prevention strategies, such as a vaccine, and build on current successes in pre-exposure prophylaxis, microbicides and treatment-as-prevention to achieve a sustainable and comprehensive, combination HIV prevention strategy

In their paper, the authors explore the challenges and opportunities associated with each of these goals, noting that an integrated strategy combining a variety of effective public health tools is needed to successfully curb HIV/AIDS in the future.

30 Years of AIDS Research - HISTORY

The understanding of HIV and AIDS has been broad and deep and has involved millions of research hours and billions of dollars. Yet, there is no cure for AIDS. There is no completely safe and effective vaccine for the prevention of AIDS. There is reasonable chemotherapy and control for the disease. There is management of AIDS and there is promise of more advances toward a better end result for AIDS patients throughout the world.

T he Centers for Disease Control in Atlanta notes that as of June, 2011 AIDS continues to be a pandemic disease that affects people almost everywhere on earth - 33 million people have already died of AIDS including about 600,000 U.S.-AIDS-related deaths. Almost 1.1 million U.S. residents, within a total population of over 300 million, are calculated to be infected and diseased with HIV.

And why are viruses, in general, and these HIV entities such a big problem and so difficult to control and cure?

· the ability to attach to specific kinds of host cells and enter those cells. Viruses use protein or glycoprotein surface projections (see embedded figure and artistic rendition below of HIV) which recognize and dock with specific biochemicals on the host cell membranes.

· the specific instructions (either DNA or RNA) needed to make the special and various proteins that direct and re-direct host cell functions for the biochemical needs of the virus.

· the ability to direct all the produced viral parts or components to be assembled into the complete virus.

· the ability to escape or exit from that host cells as dozens, hundreds or thousands of new viral particles (virions) that can survive and then later reinfect other susceptible, host cells.

How are Infecting Viruses Controlled or Killed?

· block the attachment (docking) of the viruses onto the host cell surface – this prohibits virus entrance into host cells

· interfere with viral messages or instructions

· prevent the assembly of complete and infective viruses

Many modern chemical treatments for HIV infections and AIDS involve the use of cocktails of mixed chemicals– i.e., chemically-formulated mixtures.

How and Why does Viral Chemotherapy Fail?

At this time in June of 2011 – three decades from that initial CDC report detailing pneumonia in 5 immunocompromised male patients – no universal vaccine is available to protect against the disease. Experimental vaccines continue to be produced and tested on primates and various groups of human volunteers. Only time will tell the end result of all the AIDS- and HIV-dedicated efforts. It is noteworthy that no successful, protective vaccine is available also for genital herpes, syphilis or gonorrhea despite the fact that these diseases and their infective pathogens have been known far longer than AIDS and its etiologic agent – HIV.

30 Years of HIV/AIDS: A USAID Historical Perspective

On June 5, 1981, the Morbidity and Mortality Weekly Report reported that five seemingly healthy young gay men were diagnosed with an infection that would typically affect only individuals with substantial damage to their immune system. As similar cases cropped up, national and international attention soared, and the scientific and public health community mobilized to ascertain the scope and root of this anomaly. Eventually, the causal factor was given the name AIDS.

This month marks 30 years since the first cases of AIDS were reported in the United States. After scientists identified and isolated HIV, and confirmed it caused AIDS, the U.S. Agency for International Development (USAID) began its HIV/AIDS development program. Starting in 1986, USAID’s work in this field has been ambitious and cutting edge, showcasing the best of American scientific ingenuity and demonstrating core American values.

In the 1980s and 1990s, we launched prevention, care and treatment programs through our missions around the world using approaches that fit within the social context of each country and targeted the most vulnerable populations. The proliferation of the disease across sub-Saharan Africa prompted us to intensify our focus on this region. In 2000, USAID convened the first agency-sponsored international meeting on male circumcision and HIV prevention. We also began some of the first prevention of mother-to-child transmission programs with the Elizabeth Glaser Pediatric AIDS Foundation.

We quickly realized fighting this disease would require more than just new medication and care. In 2001, we forged a partnership with the International AIDS Vaccine Initiative (IAVI) to invest in research and development for an effective vaccine. To date, IAVI has made a number of groundbreaking discoveries, including several potent new antibodies to HIV, adding more vitality to this game-changing effort. In the same year, USAID commenced three pilot trials of antiretroviral treatment in Kenya, Rwanda, and Ghana.

In 2003, President Bush announced an unprecedented initiative to ramp up the U.S. Government’s commitment to HIV/AIDS in the developing world. Today, the President’s Emergency Plan for AIDS Relief (PEPFAR) continues to be the largest bilateral AIDS program in the world, touching millions of lives through prevention, care, and treatment. Through our global network of missions and partners, USAID currently implements more than half of all PEPFAR programs.

Through PEPFAR, USAID has contributed to saving lives through a variety of voluntary prevention interventions, counseling, testing and care programs. Today, more than 3.2 million people receive lifesaving treatment through the support of the American people.

Building on the strength of PEPFAR and other successful US global health initiatives, USAID is working at an interagency level to ensure President Obama’s Global Health Initiative replicates and amplifies the success of our HIV/AIDS programs through a continued focus on health system strengthening and investments in innovation. Our award-winning Supply Chain Management System project has provided more than $750 million in HIV/AIDS commodities and saved $700 million by pooling procurements of generic AIDS drugs. We also funded the CAPRISA 004 Trial, which was completed last summer and provided the first-ever proof of concept that a microbicide can reduce risk of transmission from men to women.

Our work is far from done. We have a shared responsibility as a global partner to save lives by focusing on smart investments. The generosity of the American people has made sustained progress against this deadly disease possible. Closing the chapter on HIV/AIDS will require a steadfast focus on remaining gaps and challenges as we chart the way forward.

Thirty Years of AIDS

June 5, 2011 marked 30 years since theCDC's MMWR reported the first cases of AIDSin the U.S. Learn how we observed this day.

Content Source: HIV.gov
Date last updated: August 04, 2015

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30 years of aids research

This sexually transmitted infection is caused by a virus called HIV which attacks the immune system, making the body less resistant to normally benign diseases.

Every year there are almost 2 million new cases.

WHO reports that more and more adolescents are affected by AIDS. “Over two million adolescents aged 10 to 19 live with HIV, and many of them do not receive the necessary treatment and support to stay healthy and prevent transmission”, WHO stated on Monday.

This worrying figure has been increasing steadily over the last ten years.

30 years after discovering the virus that causes AIDS, Françoise Barré-Sinoussi, (Nobel Prize 2008), Anna-Laura Ross and Jean-François Delfraissy (Director of the ANRS – French National Agency for AIDS Research) recently published an article in Nature Review Microbiology on the major milestones of AIDS research.

They emphasise how translational research has affected the treatment and prevention of HIV. They also mention the areas of current research and future scientific challenges, particularly in the search for HIV treatment.