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
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