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IAS Members Meeting July 19th 2011

IAS Members Meeting July 19th 2011. Achievements and learning over the past 30 years: what do we need next?. Françoise BARR É-SINOUSSI Regulation of Retroviral Infections Unit Department of Virology. 30 years of HIV/AIDS Science: Main milestones. 35. SIV. HIV-2 Identification.

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IAS Members Meeting July 19th 2011

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  1. IAS Members MeetingJuly 19th 2011 Achievements and learning over the past 30 years: what do we need next? Françoise BARRÉ-SINOUSSI Regulation of Retroviral Infections Unit Department of Virology

  2. 30 years of HIV/AIDS Science: Main milestones 35 SIV HIV-2 Identification Co-receptors CD4 Depletion in gut 25 Origin of HIV HIV-1 Diversity Number of people living with HIV (million) HIV controllers Recombinants VIH-1 HIV-1 Sequence HIV Reservoirs HIV-1 O 15 HIV-1 P Innate response HIV Restriction factors CD4 Receptor HIV-1 N HIV-1 subtypes HIV-1 Identification Immune activation Microbial Translocation 5 11 81 82 84 85 86 88 89 90 95 96 97 98 00 01 02 03 05 06 07 08 09 83 87 91 92 93 94 99 04 10 AIDS Understanding the biology and pathogenesis of HIV infection: First step toward prevention and treatment strategies….

  3. 30 years of HIV/AIDS translational science… 81 82 84 85 86 88 89 90 95 96 97 98 00 01 02 03 05 06 07 08 09 83 87 91 92 93 94 04 10 11 99 Therapy and prevention research Prophylactic and therapeutic vaccine research 6,6 million 6 Number of people under HAART in LMIC UNGASS 5 Number of people annually infected with HIV 4 Number of AIDS related death in LMIC 2,5 million 3 Global Fund 2 IAS HIV 1,7 million 1 PMTCT HPTN 052 Circumcision (60%) AZT therapy Vaccine therapy AIDS First RDT HAART RV144 trial 1st phase I trial VaxGen Trial STEP Trial ARV Resistance Protease inhibitor HIV Testing Fusion inhibitor Integrase & CCR5 inhibitor HIV Quantification ARV as prevention (Caprisa, Iprex)

  4. Lessons from Vaccine trials

  5. v

  6. Evidence based Prevention Implementation of combined tools EDUCATION VACCINE CONDOMS HIV CURE STI TREATMENT MICROBICIDES TESTING COUNSELING PrEP TREATMENT AS PREVENTION CIRCUMCISION HARM REDUCTION DRUG ALCOHOL TREATMENT Highly active HIV prevention tools

  7. Early Events in HIV infection are critical Early pathogenic events: Inflammation/activation & reservoirs Critical for vaccine and cure research…

  8. How HIV persist during therapy Viral replication T cell survival Proliferation Courtesy of Nicolas Chomont - Ongoing viral replication occurs insubject on suppressive HAART (TW Chun JCI; N Tobin, J Virol 2005) - HIV integrate in long lived resting memory T cells and persist despite suppressive HAART (TW Chun, Nat Med 1995; D Finzi, Science; TW Chun PNAS 1997) - Reservoir cells, like other memory T cells, divide very slowly to maintain the memory of the immune system (A. Bosque and V. Planelles) Better knowledge of viral and host factors implicated in establishment of HIV reservoirs and in HIV persistence

  9. Why it should be possible to obtain at least functional cure for HIV/AIDS? Definition: Permanent suppression of viral replication without eradicating the virus from the body => Long-term remission + Prevention • A decrease in viral load is clearly associated with clinical benefit • Proof of concept from the Berlin patient (bone marrow transplant of CCR532 stem cells) • A small percentage (<0.3%) of HIV-1-infected subjects show no disease progression and/or spontaneous control of viral replication (e.g. long-term nonprogressors and “HIV Controllers”) • African NHP infected by SIV are naturally protected against disease progression It is time to engage in research towards an HIV Cure

  10. From C. Katlama

  11. “Towards an HIVCure” Global Scientific Strategy Sign-on the Rome Statement for an HIV Cure: www.iasociety.org

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