Q: Forty years after the discovery of the AIDS virus, the progress is immense, but can we go further?

A: Absolutely, since there are just over 38 million people living with HIV worldwide and still more than 650,000 deaths from AIDS every year.

This means that we have not yet eradicated the disease, yet we must get there because we know that with treatments, people do not develop the disease. If we can treat 100% of those infected, they will no longer develop AIDS.

But a quarter of people living with HIV still do not have access to treatment for a variety of reasons, including insufficient testing.

We must continue to expand access to treatment and care, and improve screening.

In 2021, in France, 30% of people who discovered their HIV status were at an advanced stage of infection. The sooner you are treated, the more life expectancy is the same as that of a person not infected with HIV, and the less you infect others. The messages obviously did not go over very well.

Stigma and discrimination remain present and can be obstacles to screening.

The Covid crisis has also brought activity to a halt, which fell in 2020 by 14% compared to 2019, and only increased by 8% in 2021.

Q: In recent years, several cases of HIV "cure" have been reported in patients after a bone marrow transplant to treat a tumor. Is it hope?

A: These are important advances for research because, thanks to these cases, we can learn what treatments to initiate to control the infection.

But they certainly cannot be developed on a large scale. These are extremely heavy treatments, offered to patients who had developed cancers. It was necessary to associate the transplant with immunosuppressive treatments (which reduce the action of the immune system, editor's note)...

We can still learn a lot from these patients. This is why research focuses on these cases as well as on "HIV controller" patients: rare HIV-positive people who have been treated extremely soon after their infection and who manage to maintain a viral load low enough to go without treatment.

Everything we understand about these cases is extremely important for defining new therapeutic strategies. We will not be able to eradicate HIV because this virus remains present in the body, including under treatment. But one of the main priorities of the research is that soon patients can take a treatment for a while, stop it and that when treatment stops, the virus remains controlled.

Q: What about a possible vaccine?

A: At the moment, we do not have any vaccine candidates that have shown its effectiveness. This does not mean that research on this subject stops. There are RNA vaccine candidates being studied at the moment but we are not in the same context as Covid: we are facing a much more complicated virus that attacks immune defense cells. Research is progressing, I am just a little concerned to see that fewer and fewer young people are interested in HIV research, science in general.

For AIDS, we are fortunate to have treatments but also prevention, pre-exposure prophylaxis (PreP) which works very well and which must be developed while waiting for the vaccines of the future.

© 2023 AFP