More research on prevention is needed to control the HIV / AIDS pandemic

Since the beginning of the HIV / AIDS pandemic, investigators have explored different avenues of research on ways to stop the transmission of the virus once and for all.

As scientific research progresses, health care experts continue to discuss possible timeframes for HIV vaccine or one HIV treatment, but the elimination of HIV and, even more, eradication are also of concern to many people.

Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases, held a plenary session at the R4P (HIV Research for HIV Prevention) conference in Madrid, Spain.Ending the HIV / AIDS pandemic: The critical role of the science of HIV prevention. "

With 1.8 million new infections reported in 2017, Dr. Fauci explained that, rather than focusing on elimination and eradication, the research community should focus on the fight against HIV .

He supported this argument by pointing out that smallpox is the only human disease to be eradicated in the world and that although many other human diseases have been eliminated from some parts of the world, none has been completely eradicated.

According to Dr. Fauci, prevention pathways to ending the HIV / AIDS pandemic should focus on the synergy and convergence of vaccine and non-vaccine prevention.

In the non-vaccine prevention category, items include condoms, prevention of mother-to-child transmission, voluntary male circumcision, preventive treatment and pre-exposure prophylaxis (PrEP).

In his presentation, Dr. Fauci explained the need for investigators and physicians to think realistically and not theoretically. In theory, if we could identify all people infected with HIV and put them on antiretroviral suppressive therapy, we could theoretically put an end to the HIV / AIDS pandemic tomorrow, "said Dr. Fauci. However, for a variety of reasons, including compliance rates and barriers to surveillance, it is unrealistic for this to happen.

Oral PrEP has been an effective prevention option in many populations, but it is also essential to optimize broadly neutralizing antibodies for the prevention and treatment of HIV. According to Dr. Fauci, the research areas in this category should be focused on identifying more potent antibodies and their prolongation of half-life, analysis of the in vivo production of drugs. vector-based antibodies and the search for successful combinations of antibodies.

In addition to clinical research, it is essential to focus on "incident hot spots," Dr. Fauci said. It is imperative to locate HIV groups or prevalence and compare and contrast if PrEP prescriptions are administered and fulfilled in these areas.

In addition to geographic trends, it is also important to examine demographic trends to determine which populations are most prevalent in HIV.

Finally, Dr. Fauci addressed the concept of the HIV vaccine and, according to him, could be approached in two ways.

First, researchers could produce a vaccine based on an empirical approach, testing the candidate and identifying a correlate of immunity that is a typical approach to vaccinology. However, it is also possible that the vaccine is developed assuming a correlate of immunity and designing a vaccine to induce that correlate.

Regardless of the method used, the level of effectiveness required to make the vaccine acceptable worldwide remains unknown. How to satisfy you?

In concluding his presentation, Dr Fauci concluded: "The development of a moderately effective vaccine and the optimal implementation of existing treatment prevention modalities could end the current HIV pandemic".