|
January 21, 2011
New HIV/AIDS findings
Stephen Moses is instrumental in landmark research.
REBECA KUROPATWA
First recognized in the early 1980s, HIV/AIDS was considered a fatal condition until the mid-1990s, when powerful anti-retroviral drugs were developed to fend off the devastating disease.
According to Dr. Stephen Moses, there are now effective anti-HIV drugs available that improve the health and life span of those with HIV. “The problems with the drugs are their side effects and the possibility of becoming resistant to them, but the latter can be minimized if they’re taken regularly,” he said in an interview. “There are also newer drugs available, but anti-HIV drugs must be taken for life.”
Since 1989, Moses has been working at the University of Manitoba on groundbreaking HIV/AIDS research and as a professor in the departments of medical microbiology, medicine and community health sciences, where he is associate director of global public health. From 1989-1996, Moses traveled between Winnipeg and Kenya. Since 2006, he has been living and working in Bangor, India, while also maintaining a home in Winnipeg.
It was Moses’ research team that determined that male circumcision significantly reduces the risk of acquiring HIV in male heterosexuals. In 2001, the Canadian Institute of Health Research and the U.S. National Institutes of Health funded a randomized trial spearheaded by Moses; it continued until 2006, evaluating more than 2,700 men.
“This trial showed that circumcision is protective against AIDS,” said Moses. “There was an almost 60 percent lower rate of AIDS in men participating in the trial who were circumcised.
“Circumcision helps prevent AIDS because the foreskin has many receptor cells. HIV binds very well with these particular cells and easily establishes an infection. So, the less of these cells, the less chance there is of becoming HIV positive,” he explained.
“In April 2007, the World Health Organization [WHO] and the United Nations held a consultation and presented a formal statement articulating that circumcision should be used to prevent AIDS, especially in southern and eastern Africa,” where circumcision isn’t practised, said Moses.
Since then, a number of countries have instituted circumcision programs. In 2007, Time magazine called circumcision for HIV prevention a top medical breakthrough that year.
That same year, 44-year-old Timothy Ray Brown, who had both HIV and leukemia, went to Berlin to undergo stem-cell therapy to fight his leukemia. Dr. Gero Huetter and his colleagues at Charite-University Medicine Berlin decided to perform a stem-cell transplant that also might help fight his HIV. They used stem cells from a donor who had an inherited gene mutation that left him lacking the gene receptors involved in contracting HIV, making him resistant to the virus. On the day of the transplant, Brown stopped taking the antiretroviral drugs that had been keeping his HIV at bay.
In 2009, in the New England Journal of Medicine, the Berlin doctors reported that Brown’s HIV (and leukemia) had not rebounded in the first 20 months after the transplant. Today, Brown’s cell count is like those of people without HIV. This appears to be the first time a patient with HIV has been cured.
According to Moses, “The difficulty in finding a cure stems from the fact that HIV attacks the immune system itself, which is the body’s usual means of defence against infections. The virus also mutates quickly and can evade the body’s defences, and even sometimes evade the drugs used against it.”
Progress notwithstanding, new cases of infection “far outweigh our ability to keep up with the infections through drug treatment,” said Moses. “Much more effort and funding should be going into biological and behavioral prevention research. Also, the general public can advocate governments and other organizations to allocate more funding for HIV prevention programs and research.”
Experts say the treatment is not ready for use within the general population, as it came close to destroying Brown’s immune system. Moses agreed with this cautious approach. “There have been many important discoveries made, but more is needed and having support for programs plays a critical role,” he said.
According to WHO, there are more than 50,000 new cases of HIV reported in the United States annually. By the end of 2007, there were 65,000 people living with HIV and AIDS diagnoses in Canada. Worldwide, about 33 million are living with HIV/AIDS, with 2.7 million new infections annually.
Rebeca Kuropatwa is a Winnipeg freelance writer.
^TOP
|
