The likelihood of finally finding a cure for HIV is “quite high”, a leading expert told a Dubai health conference on Monday.
Prof Sharon Lewin, director of the Peter Doherty Institute for Infection and Immunity in Melbourne, said medical advances made in recent years have given her hope that a cure will be found in the near future.
The Middle East and North Africa (Mena) region has recorded the largest increase in HIV cases over the past two decades, with cases up by 31 per cent.
Prof Lewin, speaking on the opening day of Arab Health at the Dubai World Trade Centre, said that while the rise in HIV cases in the region is alarming, the challenge will be to find an affordable cure for everyone.
“The direction the number of new cases are going in this region is alarming,” she said.
“They are going down in most parts of the world but rising here.
“The chances of finding a cure are quite high, though. The real challenge will be finding a cure that is scalable, cheap and accessible to everyone.”
A report from pharmaceutical company AstraZeneca in December said there were 180,000 people living with HIV/Aids in the Mena region.
HIV, which stands for human immunodeficiency virus, targets the body’s immune system.
If untreated, it can lead to Acquired Immunodeficiency Syndrome (Aids) — a condition that occurs when your immune system has been severely damaged by HIV, leaving you prone to life-threatening opportunistic infections and illnesses.
Access to treatment
Prof Lewin said the reason cases are increasing at such a fast rate is due to a lack of access to treatment.
“It’s down to access to treatment and policies around the criminalisation of activities that put you at risk of HIV,” she said.
“Criminalising those activities makes delivering prevention services very, very difficult.”
While the number of cases is relatively low in the region, the percentage of cases is increasing at levels higher than most other regions, she added.
According to the latest data from the World Health Organisation, there were more than 38 million people living with HIV globally in 2021.
The condition resulted in the deaths of 650,000 people around the world.
Despite the bleak picture those numbers paint, Prof Lewin was confident a cure could be found.
“I think we are going to get there,” she said.
“There’s still a lot of scientific advancement needed and we also need to have a discussion with communities around the globe about what they want from a cure.
“We need to prepare them so there’s no delays when a cure is finally found.”
Advancements in treatment
A patient in the US with leukaemia become the first woman and the third person to date to be cured of HIV after receiving a stem cell transplant from a donor who was naturally resistant to the virus that causes Aids.
Two previous cases received adult stem cells, which are more frequently used in bone marrow transplants. A fourth man was also cured in the US in July after he was given a bone-marrow transplant to treat blood cancer leukaemia from a donor who was also naturally resistant to the virus.
They are the type of advancements in treating HIV that give her confidence that a cure will eventually be found.
“If you look back at the 40 years of HIV then you will see it took around 20 years to find a treatment,” said Professor Lewin.
“Now we’ve got that treatment fine-tuned so let’s hope we can find a cure in the next 20 years.”
Advancements in retroviral medication mean people with HIV can lead long and healthy lives.
It is now widely regarded in most parts of the world as a survivable condition that is treatable with one pill a day.
Prof Lewin said the response to the Covid-19 pandemic has shown the way forward when it comes to finding a cure for HIV.
“It’s very hard to mobilise significant funds right now but we saw what happened with the response to Covid-19,” she said.
“When you’ve got a major problem that the world cares about it is possible to mobilise enough money to get things moving fast.
“HIV is still a significant problem for many, many countries.”
Preventative vaccine
Dr Bharat Pankhania, a senior clinical lecturer and infectious diseases specialist at the University of Exeter in the UK, said finding a cure for HIV would prove difficult because of the way the virus incorporated its genetic material into the DNA of the infected person.
"It would be amazing, absolutely amazing if you could uncouple that incorporated thing from the DNA," he said.
"As an infectious diseases expert, nothing is impossible, but that would be unbelievable if it was possible to see."
He suggested it was more likely that a successful preventative vaccine against HIV infection could be developed, especially given the widespread use of messenger RNA (mRNA) vaccines in protecting people from Covid-19.
"Following on from the success of the success of the mRNA vaccine, I feel we may be able to look again at finding a vaccine against HIV," he said.
"From a vaccine point of view in the next 20 years, I'm hopeful we can revisit HIV vaccination and hopefully find a vaccine that works against HIV."
