The fight against AIDS requires the whole of society to work together to genetically edit or reshape the future of the fight against AIDS

【Today's Viewpoint】

◎ Reporter Zhang Jiaxin

December 12 is World AIDS Day, and this year comes at a critical juncture: AIDS-related deaths have fallen by nearly 1 per cent since their peak in 2004, and the number of new HIV infections is at its lowest point since the 70s of the 20th century. Despite this, in 80, AIDS still kills a life every minute.

Recently, United Nations Secretary-General António Guterres addressed World AIDS Day 2023. "By 2030, we can and must end AIDS as a public health threat," he said.

The World Health Organization has set this year's theme as "Community Leadership", and the Office of the State Council AIDS Prevention and Control Committee has set this year's theme as "Gathering Social Forces to Fight AIDS Together".

Guterres stressed that the road to ending AIDS runs through society. Communities should guarantee the treatment, services and assistance that citizens need, and guarantee the right to health through grassroots activities.

Tremendous progress has been made in the fight against HIV/AIDS

It has been more than 40 years since AIDS was discovered. In 1987, the first drug against the human immunodeficiency virus (HIV), the antiretroviral drug zidovudine (AZT), was approved for the treatment of AIDS. Subsequently, the advent and development of antiretroviral therapy (ART) meant a huge step forward in the fight against AIDS.

In July, the Joint Joint United Nations Programme on HIV/AIDS (UNAIDS) announced that Botswana, Eswatini, Rwanda, Tanzania and Zimbabwe had achieved the "7-95-95" target. This means that 95% of people living with HIV know they are infected, 95% of them are on antiviral treatment, and 95% of those who are treated are virus-suppressed.

According to an article published on the British website Nature on November 11, Botswana's achievements are largely due to efforts to ensure that people living with HIV, and those most at risk of HIV, have access to life-saving interventions, including drugs to eliminate the risk of parent-child transmission, ART, condoms, voluntary circumcision, and pre-exposure prophylaxis (PrEP). All of these measures have reduced the chances of people contracting the virus.

However, to support countries in achieving this goal, we need to ensure that everyone has access to lifelong HIV care when they need it, which is the ultimate solution to ending the epidemic.

Behavioral interventions are important

"HIV detection is not a death sentence. Once diagnosed, highly effective treatment can also help reduce the spread of the disease and keep your loved ones safe. Hans Kruger, Director of the World Health Organization's Regional Office for Europe, explained, "I applaud those who offer rapid tests in communities where people living with HIV live. However, we still have some way to go to ensure that no one is left behind. ”

According to Nature, it makes sense to integrate behavioural and social sciences into the design and mainstream of health programmes, whether in terms of testing, ART, PrEP and other prevention interventions.

A good example of the importance of behavioural interventions comes from South Africa. In South Africa, men are significantly less likely than women to seek HIV testing or participate in care. In 2020, researchers provided 500 men in Cape Town with a card explaining how ART prevents HIV transmission and invited them to a mobile clinic for HIV testing. This strategy has almost doubled the number of men who come to mobile clinics for free HIV testing.

Committing to meeting individual health care needs is key not only to ending the AIDS pandemic by 2030, but also to ensuring that global health systems are resilient and resilient in the face of future public health threats.

Gene editing or reshaping the future of HIV/AIDS resistance

As of December 2022, nearly 12 million people are undergoing ART treatment, a significant increase from 3000.2010 million in 770. Although these medications can be life-saving, they can also cause side effects, such as clogged arteries in the heart and neurodegenerative diseases.

For billions of years, viruses have been at war with their hosts. The human body is like a fortress with layers of protection, so HIV uses a variety of strategies to evade the body's complex immune attack. This also makes it very difficult to develop drugs to treat AIDS. However, CRISPR gene editing technology is designed to attack the core of the virus, perhaps rendering viral strategies ineffective.

Researchers have been focusing on enhancing CRISPR tools by directly targeting the genome of host immune cells and removing integrated viral DNA from the genome of host immune cells.

In 2020, researchers at Temple University in the United States successfully used CRISPR to find HIV in the organs of mice and rats and remove key viral DNA fragments. In the same year, the same research team demonstrated that the technique was effective in macaques infected with the monkey immunodeficiency virus. This suggests that the therapy, called EBT-101, may be safe when tested in humans.

While the results are encouraging, there is still a lot of work to be done. At the end of the day, the fight against HIV/AIDS remains the theme of this year. UNAIDS calls for community leadership to be at the heart of all HIV elimination plans and programmes, to be adequately and reliably funded, and to remove barriers to community leadership.