From the time it was variously called "gay cancer
" or gay related
immunodeficiency (GRID) or community acquired immune dysfunction to its
identification and establishment as one of the most feared and controversial
diseases in modern history, the HIV/AIDS
drama as it gradually unfolded and the current challenges in AIDS management
were discussed in the inaugural session of the second International Science
Symposium on HIV and Infectious Diseases in Chennai, South India (HIV SCIENCE
2014) organized by YRG CARE India.
In her keynote address Prof François Barré-Sinoussi, Nobel Prize winner in Medicine-2008 for
HIV discovery, President, International AIDS Society, Geneva, Director
Regulation of Retroviral Infections Division, Institut Pasteur, France,
elaborated on the journey from HIV discovery to HIV
. She explained the evolution of technologies of research on retroviruses
and how clinicians mobilized the retrovirologists at the Intituit Pasteur to
arrive at the first report of LAV (lymphadenopathy-associated virus) in Science
in May 20th 1983.
Then began the crucial phase of convincing the
scientific community and public authorities that LAV was the etiological agent
of AIDS which had to be done on a war footing to identify the disease quickly
and prevent its spread. Between 1984 and '85 collaboration with Sanofi
Diagnostics Pasteur for production of viral antigens on site, saw a progression
with first generation ELISA
and first generation Western Blot test.
Prof Barré-Sinoussi outlined the challenging
task of cloning and sequencing of HIV-1 genome at that time and how the dawn of
a new era started with combined ART
. Listing the current updates on HIV research and the promises
of a functional cure of HIV, the Nobel laureate summed up the 30 years of
HIV/AIDS journey as a great example of translational research.
What we need today in
the search for a realistic "functional cure" for HIV/AIDS that promises
life-long remission after stopping therapy or long term health with ART are
novel, creative ideas, multi disciplinary collaboration partnerships between
private and public sectors, international coordination and funding. Among the 35.5
million people living with HIV (PLWH) only 9.7 million are on ART therapy and
there are an increasing number of patients in need of costly 2nd line and 3rd
Whitescarver, Director, Office of AIDS research National Institute of Health
the audience an insight into the initial challenges that the scientific
community faced in the early 1980's when very young men were diagnosed with
Pneumocytis Pneumonia Carinii (PCP), generally found only in people with
seriously compromised immune
While the disease was yet unidentified it was thought to be the result of some
infectious organism or something that went seriously wrong with the immune
system. What was more frightening was the ghastly appearance of the patients as
if they were starved for months and they were dying for unknown reasons and
that was scary.
Encouraging young scientists to think out of the
box and continue to ask questions, however weird, Dr. Whitescarver said some of
the initial guesses before HIV was discovered, were that it could be from a
sort of fungus and one clinician even guessed "it could be from dogs because
gay men sleep with their dogs!" First
cases were spotted among gay men
Haitians and hemophiliacs, but the scenario changed with heterosexual
infections and prompted a state of emergency to quickly diagnose the disease
and find a cure.
Highlighting HIV/AIDS research and treatment in
India, Dr. Suniti Solomon Founder-director YRG CARE
who documented the
first evidence of HIV infection in India in 1986, said the legal system in
India that labels homosexuality a criminal offence sends the most vulnerable
group into hiding, seriously hampering health intervention for HIV/AIDS.
in AIDS management that are India-specific revolve around socio-cultural issues
such as marriage, fertility pressure and stigma.
Very often parents of a homosexual person hide
his sexual orientation, sometimes, even the fact that he is HIV infected and
force him into marriage with an unsuspecting girl thus paving the way for
heterosexual infection. A woman is often pressurized into having a baby as soon
possible after marriage and even if she knows her husband is HIV +, the hapless
woman gets pregnant
to avoid the "barren woman" stigma and transmits HIV infection to the baby.
On the brighter side, there is now the ART revolution in India where treatment for
HIV is almost immediately available
and there is counseling, universal
precaution, advocacy, public-private partnerships, slight increase in proper
sex education to teenagers and most importantly ethical guidelines in research
were firmly established after AIDS was found in India.
The inaugural session was followed by a
community training workshop on HIV
cure: the basic facts and future direction. Interactions between participants
and experts in the field were encouraged through question and answer sessions
and a series of panel discussion and scientific paper presentations are
scheduled for the next couple of days. Accepted abstracts will be published in
the PubMed indexed journal, BMC Infectious Diseases.
The symposium attended by over 500 delegates from around the world is
scheduled from 30th January - 1st February, 2014 organized by YRG CARE, India.
Though we are now in the era of eradication, a lot of unanswered questions remain, in terms of HIV/AIDS eradication
The symposium invites young researchers to think out of the box
and come up with fresh ideas to take HIV/AIDS research to the next level to
find a permanent cure and maybe even an
eradication of the dreaded HIV/AIDS.