Friday 19 April 2024

Seeking optimal HIV treatment: building on 30 years of innovation

It has been thirty years since the discovery of Human Immunodeficiency Virus (HIV), the underlying cause of acquired immunodeficiency syndrome (AIDS). This discovery led to the development of antiretroviral therapies that have substantially improved both the quality and length of life of affected individuals. When one looks at the wide range of effective treatment options for HIV available today, the world seems a vastly different place from 30 years ago.
Dr Marty St. Clair is one of the researchers who has been directly involved in GSK’s ongoing commitment to improving the health and lives of those with HIV. In the early 1980s, she was part of the team who discovered and helped develop the very first HIV drug – azidothymidine (AZT, also known as zidovudine)1.
The development of AZT occurred in a relatively short time span. Within a year of the first reports of virus isolation, scientists at Burroughs Wellcome (later GSK) were screening compounds for anti-HIV activity. In just under three years from the first screening activities, AZT was approved by the US Food and Drug Administration on March 19, 1987.  This amazingly short timeline is testament not only to the hard work, collaboration and diligence of the scientists involved, but to the seriousness of the situation. Faced with this challenge, scientists from all over the world worked together to achieve a common goal, and, given the complexities involved, this was considered a major achievement. Today, Dr St. Clair continues to be directly involved in HIV drug discovery and development.1
Thirty years on from development of the first antiretroviral, there remain a number of significant challenges: people living with HIV still face stigma and discrimination, are reluctant to get tested, disclose their HIV status or take antiretroviral therapy. Recent ECDC research2 has revealed that nearly half of all HIV cases are diagnosed late.
A sharp and steady increase in the number of reported HIV infections has been noted in Malta over the last five years, with 61 new cases of HIV reported in 2015 compared to 17 new cases reported in 2010 (Times of Malta, December 1, 2016)3. This requires an urgent call for action to increase awareness of HIV infection and ensure that people at most risk of contracting the disease are tested and if required, receive optimal treatment early on in the disease.
Since the development of AZT just over 30 years ago, more efficacious and tolerable treatments have been developed. Optimal HIV treatment leads to sustained viral suppression which is key to achieving the ambitious United Nations treatment goals that aim to end the AIDS epidemic by 20304. The question in Malta remains: are HIV patients getting the best and the latest anti retroviral therapy (ART)?