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The Future of HIV/AIDS: The Road to a Cure

The Future of HIV/AIDS: The Road to a Cure. Ongoing viral replication occurs in subjects on suppressive HAART (TW Chun, JCI; N Tobin, J Virol 2005).

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The Future of HIV/AIDS: The Road to a Cure

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  1. The Future of HIV/AIDS: The Road to a Cure

  2. Ongoing viral replication occurs in subjects 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) How HIV persists during therapy? Viral replication T cell survival Proliferation Courtesy of Nicholas Chomont

  3. What is our goal? Eradication vs Remission

  4. Intensification of HAART (+/- other interventions) Early initiation of HAART (limit viral reservoirs) Improved Drugs (penetrating anatomical compartments) Reactivation of HIV replication from latent reservoirs: ”Shock and Kill” What strategies to control/eradicate reservoirs? 1/2 HAART Cytokines, chemical compounds… HAART HAART Uninfected cells HAART HAART HAART HIV-induced cell death Courtesy of Nicholas Chomont

  5. Interfering with immunological mechanism that contribute to HIV persistence Other therapeutic interventions (Gene/Mol therapy, therapeutic vaccine) Antibodies, cytokines, gene therapy, chemotherapy T cell survival Proliferation What strategies to control/eradicate reservoirs? 2/2 Courtesy of Nicholas Chomont

  6. Keep patients ready by: Universal Access Early Treatment - Limit reservoirs and preserve the immune system Invest in research: Better understanding of biological mechanism and role of the immune system in establishing reservoirs and persistence Better tools and models In vitro and in vivo models More precise assays and sensitive techniques Drug development: increased specificity for latently infected cells Develop translational research While we are searching: Inspired from Sharon Lewin

  7. While the Global Fund keeps working towards Universal Access: IAS to coordinate and support the creation of an international multidisciplinary scientific advisory group on HIV Reservoirs to develop a Global Scientific Strategy « Towards an HIV Cure » A Global Scientific Consortium « Towards an (functional) HIV Cure » ? Global Scientific Strategy Towards an HIV Cure

  8. Acknowledgements • International AIDS Society, Geneva: • Shirin Heidari • Marie-Capucine Penicaud • Tamara Torri • Julie Pluies • Anthony Flynn • With courtesy of members of IAS Core Group Towards An HIV Cure who shared their slides: • 􀁹 Nicolas Chomont, Vaccine and Gene Therapy Institute Florida, USA • 􀁹 Tae-Wook Chun, National Institutes of Health, USA • 􀁹 Sharon Lewin, Burnet Institute, Melbourne, Australia

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