Even a little before the start of the 25th International AIDS Conference (IRC), which took place from July 22 to 26 in Munich (Germany), the results of a study from South Africa were more than convincing. When injected twice a year, we were able to measure the effectiveness of lenacapavir at 100% on a group of young women who were not infected with the HIV/AIDS virus. Dr. Jean-Pierre Routy, doctor at the McGill University Health Center, was in Munich. We met him.
Manufactured by the company Gilead Sciences, its expensive price puts off experts who ask the pharmaceutical company to reduce it. Furthermore, it was also discussed about an HIV-positive person who received a bone marrow transplant and who shows signs of remission, meaning that HIV has no longer been present in his blood for several years now. There was something to delight these thousands of delegates. “This is the first congress where we really observe that COVID is behind us and that more than 15,000 people are present and not virtually,” notes Dr. Jean-Pierre Routy, doctor at the University Health Center. McGill who attended this gathering. It is in a way a great secular communion of the fight against AIDS, to be all together and to celebrate all the work accomplished by all these people who come from the world of research, education, medicine, prevention, etc. It’s very vast. This is where the media coverage is very strong if we compare to the CROI [Conference on Retroviruses and Opportunistic Infections, un congrès scientifique, NDLR]For example. It was also good to see people from Africa, there were more than 1000 people invited by the CIR and it led to very good discussions on the situation in certain countries. There is this feeling of being together and sharing a great moment […] »
“In 2023, just under 40 million people were living with the AIDS virus, the human immunodeficiency virus (HIV), reveals the organization’s annual report. About 1.3 million [de personnes] were infected last year (2022), some 100,000 fewer than a year earlier,” as stated in a - article citing a new UNAIDS report ahead of this 25th International Conference. It should be remembered that more than 42 million people have died from AIDS since the discovery of this disease in the 1980s.
Not a miracle treatment, but…
“As at the Vancouver Conference in 1996, where the arrival of triple therapies was announced, there was a standing ovation when Dr. Linda-Gail Bekker came to present the study on lenacapavir,” continues Dr. Routy. It was a magnificent moment, it was huge because the study on lenacapavir opens up many possibilities. Lenacapavir was 100% effective in young women and girls at risk of infection in this study report from South Africa. It was incredible! »
Dr Linda-Gail Bekker is director and professor at the Desmond Tutu HIV Foundation at the University of Cape Town and former president of the International AIDS Society (2016-2018) which organizes these major conferences.
Indeed, lenacapavir (Sunlenca) only requires two annual doses per injection. It can be used for PrEP (preventative treatment). It was approved by Health Canada in November 2022. But here it is: “Lenacapavir is “lonely”, that is to say it needs another drug to help and support it, explains the Dr Jean-Pierre Routy. He needs a medicine from another family, unfortunately. […] But this is only the beginning, the trend in the industry will now be to move from “tritherapy” to “dual therapy”. We also observe that these drugs are less toxic than they were. […] We will have medications once a month, like cabotegravir [produit par Viiv Healthcare en injection]For example. Here again, we point towards dual therapy. It’s a great advancement that opens many doors, again it was extraordinary to see that! […] ».
On the other hand, the big downside for lenacapavir is currently its prohibitive cost, currently $55,000 for two doses. “I know that there are very strong debates on the price of the drug, there is a lot of pressure. Gilead’s advertising image is so strong that it could benefit it to fold. I’m not an expert in setting prices, but I think Gilead could make an effort here, the drop would be offset by the number of patients on this treatment[…]», comments this doctor who is the director of the FRQ-S AIDS and Infectious Diseases Network. Will Gilead Sciences heed the experts’ pleas? That is the question…
“The new patient from Berlin”
There was other good news, since there was ample discussion about a bone marrow transplant patient who, by all scientific evidence, had been in remission from HIV for several years. This was revealed a few days before the Conference and then widely discussed by the scientific community during this congress.
But what is it exactly? Well, he is a 60-year-old man who did not want to be identified, who was declared HIV positive in 2009, then in 2015, and who received a bone marrow transplant following leukemia. Six years later, we see that he no longer has a viral load, and has not for several years, although he had apparently stopped his antiretroviral treatments in 2018. These are the data presented by Dr Christian Gaebler from the Charité Hospital in Berlin, who is the treating doctor of this patient: “[…]the case of this patient is very suggestive of a cure for HIV,” he told AFP. This German patient is probably the 7th case of long-term remission. Timothy Ray Brown was the “first patient in Berlin” cured of HIV-AIDS (in 2008) according to scientists. He died of cancer in 2020.
But now the “new patient from Berlin” received stem cells from bone marrow donors with a rare mutation in a gene called CCR5, a mutation already recognized in HIV-AIDS circles to block the entry of this virus in cells. “[…]These donors had inherited two copies of the mutated gene — one from each parent. The new patient from Berlin is the first to have received stem cells from a donor who inherited only one copy, a much more common configuration raising hopes for more potential donors.
“This patient received only one of the two genes and it worked, it could have led to a cure, it is scientifically interesting, but it is a very small step in the right direction,” indicates Dr. Jean-Pierre Routy. This was of course highly publicized because the patient is German and the congress was taking place in Munich. We will now be able to find donors more easily; both parents must carry the CCR5 gene. But bone marrow transplantation remains very, very rare. This doesn’t change much in everyday life, but it is worth continuing your studies in this direction. […] »
“Each international conference on AIDS brings scientific advances that could open the door to new cures. As a beneficiary of triple therapy, a transplant between HIV-positive donor and recipient, and the I=I (undetectable=untransmittable) advance, I agreed to have my case published in the mainstream media in order to contribute to destigmatization of people living with HIV. My journey shows how medical advances have transformed my life, but these advances will only reach their full potential if every individual, regardless of their situation, can access the necessary care. The fight against stigma and discrimination is essential to allow everyone to benefit from available treatments without fear of judgment or exclusion,” commented Montrealer Denis Cormier-Piché, who is the first North American to benefit. of an organ transplant between donor and recipient living with HIV-AIDS.
COMING SOON… In a future article, we will address the questions and issues related to research for a vaccine, as well as questions about the acceptability of homosexuality in Africa.
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