HIV: Use of neutralizing antibodies calls attention of scientific community, says Esper Georges Kallás

Publicação: 12 de December de 2017

To infectious diseases specialist, the use of neutralizing antibodies to attempt a viral infection cure is a theoretical goal, but is beyond demonstrations of treatment and prevention

Our collaborative project Believe aims to explore ways to cure HIV infection using strategies that use cell re-education to act specifically against the vírus

Since the beginning of the Aids epidemic, 36 years ago, scientists have accomplished great advances treating the diseases There is great hope of developing an effective cure able to be applied in large scale. Moreover, the perspective of science developing a way to eliminate the HIV seems to be closer. To infectious diseases expert Esper Georges Kallás, the discovery of increasingly powerful antibodies has enchanted this research field. He explains there are already antibodies, in low concentrations that neutralize over 96% of isolated HIV viruses and can have a half-life in the blood of over 6 months. “Using neutralizing antibodies has drawn great attention of the scientific community and there are studies in phase III that assess the VRC01 (one of the first antibodies developed for human use) in HIV infection prevention”, he stresses.

Other clinical studies are assessing neutralizing antibodies to treat people living with the HIV. Using neutralizing antibodies to attempt a viral infection is a theoretical goal, but that, according to the expert, is beyond demonstrations of treatment and prevention. “I think we must assess such facts in order to know if they will be sufficiently capable of eliminating the virus”, he says while stressing that his group at São Paulo University (USP) is part of a collaborative project called BELIEVE, which is aimed at exploring ways to cure HIV infection using strategies that apply cell re-education to act specifically against the virus.

Despite being optimistic about the research’s advances in developing a way to cure the HIV, he admits is necessary to increase funding in the field and train new researchers, in Brazil and in other countries. “Only increasing the critical mass of researchers will increase the chances of success”, he points while regretting the number of researchers dedicated to HIV infection studies in Brazil has dropped proportionally over the past years. “Deepened by the crisis in public funding for Brazilian science we have seen many young talents leaving the field, or migrating to other activities or even leaving the Country”, he alerts.

To avoid this, the physician argues it is fundamental to reinforce the notion that strong science is inseparable of a strong nation. In his opinion, breaking the investment flow will lead to severe consequences, which will be perceived in the next years, because research investment does not aim at results from a single project; it eventually creates an infrastructure that assists HIV infection research as well as other knowledge fields. “An example were the great contributions of Brazilian scientists, some that studied the HIV, towards understanding the Zika outbreak”, he reminds.

Treatment of people living with the HIV

Regarding the antiretroviral therapy available in Brazil, the infectious disease specialists ensures it is excellent. “We use a single pill (3TC, TDF, EFZ) and, since the beginning of the year, all those recently diagnosed can take a combination of two daily pills, which induces to a very low side effect frequency (3TC, TDF and dolutegravir). Treatment compliance has increased and, in some places, over 90% of the people under treatment have an undetectable HIV viral load in the blood.

To Dr. Kallás it is possible to enhance the treatment of people living with HIV in the world. The use of long duration injectable medications has become an alternative, which would allow viral suppression with injections given every month or two. Other strategies, including the use of neutralizing antibodies with long plasma half-life have also been explored. “An injectable treatment would benefit life quality and compliance of people who have difficulties taking pills every day. However, there must be more precise results and new studies to reach this conclusion”, he admits.

Brazilian medication for HIV patients

People living with the HIV have a slightly higher risk of developing heart disease. Pitavastatine and similar drugs are often used to decrease cholesterol levels and, thus, decreasing the risk of heart diseases among these people. Doctor Kallás mentions an ongoing study to assess whether pivastatine is able or not to reduce cardiovascular events among these people and those with low-risk for such outcomes.

This study was called REPRIEVE and is joined by several Brazilian centers, including USP. “We are currently including volunteers”, he says while adding that another part of the study with statins in HIV infection and its effect reducing the inflammation, observed by several researchers, will be to assess if long-term use of statins could reduce the inflammation caused by the virus and benefit this other way.

Despite the advances, Brazil is the Country holding most of new HIV infections in Latin America with 49%of new infections – according to estimates by UNAIDS. Still according to data, from the 4500 new HIV infections in adults in 2016, 35% were among people from 15 to 24 years-old. While nearly all patients ask their physicians when the HIV cure will be available, in Brazil, every 15 minutes, a person is infected with the HIV. AIDS expansion among youngsters (15 to 24 years-old) is still a concern and actions in this sense should be intensified. The number of deaths related to AIDS in the Country was estimated by UNAIDS in 14,000 [9,700 – 19,000] in 2016.…