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HIV vaccine remains 'holy grail' of treatment
Irish Examiner 28/02/2007
By Conor Kane

Advances in treatment mean that a diagnosis of HIV is no longer viewed as being a death sentence and patients can live healthily for years on well-managed medication.

Various breakthroughs in HIV therapy were made during the late 1980s and 1990s, and will no doubt continue to be made in the years to come as doctors attempt to control the progression of the virus and lengthen a patient's expected lifespan.

However, the 'holy grail' of HIV treatment - a vaccine - remains little more than a dream, with no sign of any definitive medical prevention on the horizon. However, there are at least 20 trials of many different vaccine 'candidates' going on around the world. Experts in the field suggest an absolute minimum of five to seven years before it can be proven that any of these candidates actually prevent infection.

The main weapon in the armoury against HIV remains Highly Active Anti-Retroviral Treatment (HAART), combinations of at least three anti-HIV drugs which - when taken together as part of a disciplined medication regime - suppress the virus and can even reverse some of the damage already caused to the body's immune system. The first anti-retroviral drug was Azidothymidine (AZT), first used in 1987.

HIV drugs are not a cure but, by preventing the virus from replicating itself, they can slow or stop the progression of the disease. Drug combinations are often taken from different classes of medication which deal with different stages of the virus's life cycle, hitting it at various points of development. The use of multiple drugs also makes it harder for HIV to mutate into a more resistant form. Doctors, nurses and counsellors always stress the importance of adherence to any drug cocktail regime as consistent levels of the medication need to be in the body at all times to remain effective.

Non-adherence is one issue for patients, another is drug resistance - when HIV becomes resistant to a particular drug or combination, that medication will have to be changed and a new regime put in place. Meanwhile, those working in HIV prevention and treatment are anxious that the public should avoid complacency. As one professional put it: "One of the myths is that, because it's not a death sentence, you don't have to worry about getting it. But it's still growing.