IAVI REPORT – VOL. 14, NO. 1, 2010
We’ve entered the fourth decade in the battle against HIV/AIDS. The first was indelibly marked by the quick and certain death HIV infection brought. The landmark discovery in the second decade of HIV was the introduction of highly active antiretroviral therapy, the combination of drugs that rescued many HIV-infected people from the brink of death. In the third decade, considerable progress was made in delivering these life-saving antiretrovirals (ARVs) to millions of people in need, particularly in low- and middle-income countries.
What will be the most important accomplishment of this decade? Many hope it will be significant progress in developing new methods to protect people against HIV.
AIDS vaccine researchers, who were buoyed last year by the first evidence of vaccine-induced protection in humans and the discovery of several new broadly neutralizing antibodies against HIV, will likely reap important new insights in this decade that could lead to the development of an effective preventive vaccine. Some of these insights may relate to the role of innate immunity in protection against HIV, and specifically the non-neutralizing functions of antibodies that recruit innate immune responses (see Antibodies: Beyond Neutralization). Also, the next few years will bring a flurry of results from studies of pre-exposure prophylaxis (PrEP), an HIV prevention strategy that entails administering ARVs either orally or in a microbicide gel to uninfected people in an attempt to protect them against infection.
HIV vaccine research and PrEP, along with test and treat—universal testing and immediate treatment of infected individuals—were among the main topics that headlined the 17th Conference on Retroviruses and Opportunistic Infections that took place in February (see Prevent and Conquer). Many other basic research discoveries were showcased in January at the annual Keystone Symposia on HIV Biology and Pathogenesis (see On the Scientific Trail in Santa Fe).
More than ever, researchers are focusing on preventing the spread of the virus, optimizing treatment for individuals who are already infected, and eventually finding a cure for HIV. Given this, the fourth decade of the pandemic should bring us even closer to the ultimate goal—conquering AIDS.
—Kristen Jill Kresge, Managing Editor