Chasing A New Way To Prevent HIV: Passive Immunization
The Man Who Was Nearly Cured of HIV
Research Dampens Hopes of HIV Cure, Shows Progress on Remission Without Drugs
AIDS Stigma Prompts China to Sell HIV Tests in Campus Vending Machines
New HIV Studies Offer Fresh Hope for a Cure
People Who Are HIV-Positive May Age Faster
Truvada, the Miracle HIV Drug Few People Take, Suffers Another Setback
A Cure for AIDS: Scientists Say It's 'On the Horizon'
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On Twitter @lindseyhoshaw","avatar":"https://secure.gravatar.com/avatar/274b07694c998eaa8f26cfabaa941186?s=600&d=blank&r=g","twitter":"lindseyhoshaw","facebook":"lindsey.hoshaw.9","instagram":null,"linkedin":null,"sites":[{"site":"arts","roles":["author"]},{"site":"news","roles":["subscriber"]},{"site":"futureofyou","roles":["editor"]},{"site":"bayareabites","roles":["contributor"]},{"site":"stateofhealth","roles":["author"]},{"site":"science","roles":["edit_theme_options","subscriber"]},{"site":"quest","roles":["edit_post_subscriptions","edit_usergroups","unfiltered_html","unfiltered_upload","leadcoordinator","editor"]},{"site":"food","roles":["contributor"]}],"headData":{"title":"Lindsey Hoshaw | KQED","description":"KQED Contributor","ogImgSrc":"https://secure.gravatar.com/avatar/274b07694c998eaa8f26cfabaa941186?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/274b07694c998eaa8f26cfabaa941186?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/lindseyhoshaw"}},"breakingNewsReducer":{},"campaignFinanceReducer":{},"firebase":{"requesting":{},"requested":{},"timestamps":{},"data":{},"ordered":{},"auth":{"isLoaded":false,"isEmpty":true},"authError":null,"profile":{"isLoaded":false,"isEmpty":true},"listeners":{"byId":{},"allIds":[]},"isInitializing":false,"errors":[]},"navBarReducer":{"navBarId":"home","fullView":true,"showPlayer":false},"navMenuReducer":{"menus":[{"key":"menu1","items":[{"name":"News","link":"/","type":"title"},{"name":"Politics","link":"/politics"},{"name":"Science","link":"/science"},{"name":"Education","link":"/educationnews"},{"name":"Housing","link":"/housing"},{"name":"Immigration","link":"/immigration"},{"name":"Criminal Justice","link":"/criminaljustice"},{"name":"Silicon Valley","link":"/siliconvalley"},{"name":"Forum","link":"/forum"},{"name":"The California Report","link":"/californiareport"}]},{"key":"menu2","items":[{"name":"Arts & Culture","link":"/arts","type":"title"},{"name":"Critics’ Picks","link":"/thedolist"},{"name":"Cultural Commentary","link":"/artscommentary"},{"name":"Food & Drink","link":"/food"},{"name":"Bay Area Hip-Hop","link":"/bayareahiphop"},{"name":"Rebel Girls","link":"/rebelgirls"},{"name":"Arts Video","link":"/artsvideos"}]},{"key":"menu3","items":[{"name":"Podcasts","link":"/podcasts","type":"title"},{"name":"Bay Curious","link":"/podcasts/baycurious"},{"name":"Rightnowish","link":"/podcasts/rightnowish"},{"name":"The Bay","link":"/podcasts/thebay"},{"name":"On Our Watch","link":"/podcasts/onourwatch"},{"name":"Mindshift","link":"/podcasts/mindshift"},{"name":"Consider This","link":"/podcasts/considerthis"},{"name":"Political Breakdown","link":"/podcasts/politicalbreakdown"}]},{"key":"menu4","items":[{"name":"Live Radio","link":"/radio","type":"title"},{"name":"TV","link":"/tv","type":"title"},{"name":"Events","link":"/events","type":"title"},{"name":"For Educators","link":"/education","type":"title"},{"name":"Support KQED","link":"/support","type":"title"},{"name":"About","link":"/about","type":"title"},{"name":"Help Center","link":"https://kqed-helpcenter.kqed.org/s","type":"title"}]}]},"pagesReducer":{},"postsReducer":{"stream_live":{"type":"live","id":"stream_live","audioUrl":"https://streams.kqed.org/kqedradio","title":"Live Stream","excerpt":"Live Stream information currently unavailable.","link":"/radio","featImg":"","label":{"name":"KQED Live","link":"/"}},"stream_kqedNewscast":{"type":"posts","id":"stream_kqedNewscast","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/newscast.mp3?_=1","title":"KQED Newscast","featImg":"","label":{"name":"88.5 FM","link":"/"}},"futureofyou_440869":{"type":"posts","id":"futureofyou_440869","meta":{"index":"posts_1591205157","site":"futureofyou","id":"440869","score":null,"sort":[1524250800000]},"guestAuthors":[],"slug":"chasing-a-new-way-to-prevent-hiv-passive-immunization","title":"Chasing A New Way To Prevent HIV: Passive Immunization","publishDate":1524250800,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>After decades of intense effort, an effective vaccine against HIV is not on the horizon — and, some say, may never be possible. So some AIDS researchers are going passive.\u003c/p>\n\u003cp>As in passive immunization.[contextly_sidebar id=\"Xmf3XI2gbMPO20A46mYbeYfSv5R7TcOk\"]\u003c/p>\n\u003cp>Active immunization is what an effective vaccine does. It stimulates the recipient to make antibodies that protect against a disease. Passive immunization involves the direct injection of antibodies extracted from survivors of a particular infection.\u003c/p>\n\u003cp>It's an \u003ca href=\"https://academic.oup.com/cid/article/51/2/239/303856\" target=\"_blank\" rel=\"noopener\">old method\u003c/a> of preventing infection when a vaccine isn't available — once used, for instance, to protect at-risk people from hepatitis before vaccines were developed. Instead of the lifelong protection from a really good vaccine, passive immunization is a temporary bulwark against infection.\u003c/p>\n\u003cp>A \u003ca href=\"https://www.nature.com/articles/s41591-018-0001-2\" target=\"_blank\" rel=\"noopener\">new report\u003c/a> in \u003cem>Nature Medicine \u003c/em>gives reason to believe it can work against HIV — at least, so far, in monkeys.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[contextly_sidebar id=\"7iTJpxzoihSEFdeAGr40HVv2JFxPnQpZ\"]A single injection of two anti-HIV antibodies protected five of six macaque monkeys from infection for six to nine months as they got weekly inoculations of a potent human-simian hybrid of the virus called SHIV.\u003c/p>\n\u003cp>\"We think this approach might be an important way to prevent transmission in humans, particularly in regions of the world where HIV is endemic,\" says \u003ca href=\"https://irp.nih.gov/pi/malcolm-martin\" target=\"_blank\" rel=\"noopener\">Malcolm Martin\u003c/a>, chief of the viral pathogenesis and viral section of the National Institute of Allergies and Infectious Diseases and a senior author of the paper. \"This is not a vaccine but a way to prevention.\"\u003c/p>\n\u003cp>\u003ca href=\"https://www.gatesfoundation.org/Who-We-Are/General-Information/Leadership/Global-Health/Emilio-Emini\" target=\"_blank\" rel=\"noopener\">Emilio Emini\u003c/a>, director of the Gates Foundation's HIV program, a funder of the new research, agrees the approach is worth pushing. \"The potential is there for the development of a neutralizing antibody cocktail that could be injected to provide many months of protection against HIV infection,\" Emini says. (The Gates Foundation is also a funder of NPR and this blog.)\u003c/p>\n\u003cp>Over the last few years, scientists have identified something like 100 of these anti-HIV antibodies, giving them plenty of opportunities to mix and match for maximum effectiveness.\u003c/p>\n\u003cp>The hope is that an injection of these antibodies every six to 12 months could protect large numbers of people from HIV in parts of the world where most infections are occurring. Currently 1.8 million people are newly infected with HIV every year. And other means of prevention, such as a daily pill containing anti-HIV drugs, have proved too cumbersome. \"Taking a pill every day can be just about impossible to do in a population of young people, even under the best of circumstances,\" Emini says.\u003c/p>\n\u003cp>And protecting that young population is key. \"In southern Africa, in particular, over the past 10 or 15 years there's been an explosion of young people,\" Emini says. \"In many of these countries the average age is in the 20s. Having the means to protect these young people is something that will be absolutely critical to controlling the epidemic.\"[contextly_sidebar id=\"jyiWKAHmWck20bKRGd11NV0NQ6LVdv2F\"]\u003c/p>\n\u003cp>The \u003cem>Nature Medicine \u003c/em>paper is just the latest report from a burgeoning new branch of HIV research that's gathering momentum.\u003c/p>\n\u003cp>\"This is not just about doing cool science — and this is cool science,\" says Mitchell Warren, executive director of \u003ca href=\"https://www.avac.org/\">AVAC\u003c/a>, a global HIV prevention advocacy group. \"People are excited about this antibody research as a whole new prevention approach. The long-term goal is still a vaccine. But in HIV prevention we will take what we can get.\"\u003c/p>\n\u003cp>But if you've been following AIDS, you might be wondering how antibodies from HIV-infected people could possibly protect against infection. After all, the hallmark of HIV infection is that immune defenses don't work.\u003c/p>\n\u003cp>The answer is that researchers are using antibodies derived from a tiny fraction of HIV-infected people — about 1 percent — called \"elite controllers\" or (the term Martin prefers) \"elite neutralizers.\" As his term indicates, these \"elite\" patients make antibodies that can neutralize, or kill, HIV. The patients typically have low levels of the virus and can live longer without virus-suppressing drugs before they get symptoms of immune system collapse, or AIDS.\u003c/p>\n\u003cp>Ultimately, most elite neutralizers do progress to AIDS if they don't take antiviral drugs. The reason, Martin says, is that during the initial stages of their HIV infection, their immune system \"takes a major hit from which it never recovers.\" That allows HIV to establish hideaways, or reservoirs, in the body. By the time their immune systems start generating antibodies to neutralize HIV, Martin says, \"it's too late\" to keep the infection under control forever. The horse is out of the barn.\u003c/p>\n\u003cp>[contextly_sidebar id=\"w4gEpTxAayvKFMwRczIPppV0noiBfi2u\"]In the new work and \u003ca href=\"https://www.npr.org/sections/health-shots/2013/10/31/242093426/aids-scientists-encouraged-by-antibodies-that-hit-monkey-virus)\">previous experiments\u003c/a>, Martin and colleagues have identified the particular antibodies from these rare patients that can prevent HIV infection in the test tube. They then harvest these antibodies from patients and test them in monkeys to see if they prevent HIV infection from getting established in the first place. They've also learned to tweak the antibodies, introducing mutations that extend their lifetime in the bloodstream. And they've found that passive immunization works best when they combine two types of antibodies in one injection.\u003c/p>\n\u003cp>Two other findings improve the prospects that passive immunization may work in the real world:\u003c/p>\n\u003cul>\n\u003cli>It can be given by subcutaneous injections — a simple jab just under the skin — a much simpler and cheaper maneuver than the intravenous infusions used in earlier studies.\u003c/li>\n\u003cli>Small doses — three times lower than earlier IV doses — were enough to give many months of protection. That will bring the cost down too.\u003c/li>\n\u003c/ul>\n\u003cp>These elements \"make this report very important,\" Emini says. \"Everything is moving in the right direction.\"\u003c/p>\n\u003cp>Martin says another promising factor is the likelihood that the injected antibodies will stick around longer in humans' bloodstream than they do in monkeys' – thus offering more durable protection.\u003c/p>\n\u003cp>That's because a monkey's immune system recognizes the human-derived antibodies as foreign and so generate antibodies against the antibodies, clearing them from the blood. In studies when humans have been injected with these antibodies, Martin says, \"so far, there has been no report of humans ever developing anti-antibodies. So it's very likely, though we don't have proof of this, that these antibodies will last longer when we give them to humans.\"\u003c/p>\n\u003cp>The antibody cocktail researchers envision would contain neutralizing antibodies directed at multiple parts of the HIV outer coat. That would work against various strains of HIV circulating around the world and reduce the risk the virus would develop resistance.\u003c/p>\n\u003cp>Still, genetically engineered antibodies \"are actually quite expensive to produce,\" Emini acknowledges. \"So we need to develop ways to produce them at cost levels that are realistic for countries where most of the infection still occurs.\" The Gates Foundation's target price is no more than $150 per person per year — an amount comparable to the cost of HIV drug treatments now \u003ca href=\"https://www.npr.org/sections/health-shots/2013/10/31/242093426/aids-scientists-encouraged-by-antibodies-that-hit-monkey-virus)\">reaching 21 million people a year\u003c/a>.\u003c/p>\n\u003cp>Momentum behind the passive immunization against HIV is [contextly_sidebar id=\"qBSUXVbfErfptQT2yYDrSIGwPatdWI2n\"]growing. \u003ca href=\"https://www.avac.org/trial-search?field_prevention_option_tid%5B%5D=1&keys=&title=&field_status_value=Ongoing&field_phase_value=All\">Eight human studies are underway\u003c/a> using the approach.\u003c/p>\n\u003cp>Two of them are enrolling a total of 5,000 people at risk of HIV infection — men who have sex with men in the United States, Latin America and South Africa, and women in seven African countries.\u003c/p>\n\u003cp>Those trials are using one of the first of the 100 anti-HIV antibodies to be discovered, called VRC01. But it has to be delivered every two months in 45-minute intravenous infusions. So even if that's shown to be effective in preventing HIV infections, it's not going to be practical as a real-world prevention strategy.\u003c/p>\n\u003cp>The two-antibody combination in the new report might be. It's being injected into humans in a small study that began last August. It's designed to see if any adverse effects arise, but it can also yield useful data on how long the antibody persists in humans and whether humans mount an immune defense against them.\u003c/p>\n\u003cp>Even though the monkey studies and human trials are preliminary, there's a sense of urgency behind the passive-immunization approach. Despite surprising success in getting anti-HIV treatment to infected people in most-affected nations, nobody thinks the world can treat its way out of the HIV pandemic.\u003c/p>\n\u003cp>\"The concern is that if we don't control the pandemic, 15 or 20 years from now we'll have more people with HIV in southern Africa than we had 15 years ago,\" Emini says. \"So the urgency remains very strong, and getting stronger.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Richard Knox is a New Hampshire-based health and science reporter, former NPR science correspondent and currently senior correspondent for WBUR in Boston. He's been reporting on HIV/AIDS since the beginning of the epidemic. Contact him @DickKnox\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Chasing+A+New+Way+To+Prevent+HIV%3A+Passive+Immunization&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"The idea is to inject anti-HIV antibodies that would kill the virus when people get exposed. A new study is promising — although it was conducted on monkeys.","status":"publish","parent":0,"modified":1524244262,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":32,"wordCount":1474},"headData":{"title":"Chasing A New Way To Prevent HIV: Passive Immunization | KQED","description":"The idea is to inject anti-HIV antibodies that would kill the virus when people get exposed. A new study is promising — although it was conducted on monkeys.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"440869 https://ww2.kqed.org/futureofyou/?p=440869","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/04/20/chasing-a-new-way-to-prevent-hiv-passive-immunization/","disqusTitle":"Chasing A New Way To Prevent HIV: Passive Immunization","source":"Hope/Hype","nprImageCredit":"Foto24","nprByline":"Richard Knox, NPR","nprImageAgency":"Gallo Images/Getty Images","nprStoryId":"603525972","nprApiLink":"http://api.npr.org/query?id=603525972&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/goatsandsoda/2018/04/18/603525972/chasing-a-new-way-to-prevent-hiv-passive-immunization?ft=nprml&f=603525972","nprRetrievedStory":"1","nprPubDate":"Thu, 19 Apr 2018 11:21:00 -0400","nprStoryDate":"Wed, 18 Apr 2018 13:41:00 -0400","nprLastModifiedDate":"Thu, 19 Apr 2018 11:21:15 -0400","path":"/futureofyou/440869/chasing-a-new-way-to-prevent-hiv-passive-immunization","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>After decades of intense effort, an effective vaccine against HIV is not on the horizon — and, some say, may never be possible. So some AIDS researchers are going passive.\u003c/p>\n\u003cp>As in passive immunization.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Active immunization is what an effective vaccine does. It stimulates the recipient to make antibodies that protect against a disease. Passive immunization involves the direct injection of antibodies extracted from survivors of a particular infection.\u003c/p>\n\u003cp>It's an \u003ca href=\"https://academic.oup.com/cid/article/51/2/239/303856\" target=\"_blank\" rel=\"noopener\">old method\u003c/a> of preventing infection when a vaccine isn't available — once used, for instance, to protect at-risk people from hepatitis before vaccines were developed. Instead of the lifelong protection from a really good vaccine, passive immunization is a temporary bulwark against infection.\u003c/p>\n\u003cp>A \u003ca href=\"https://www.nature.com/articles/s41591-018-0001-2\" target=\"_blank\" rel=\"noopener\">new report\u003c/a> in \u003cem>Nature Medicine \u003c/em>gives reason to believe it can work against HIV — at least, so far, in monkeys.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>A single injection of two anti-HIV antibodies protected five of six macaque monkeys from infection for six to nine months as they got weekly inoculations of a potent human-simian hybrid of the virus called SHIV.\u003c/p>\n\u003cp>\"We think this approach might be an important way to prevent transmission in humans, particularly in regions of the world where HIV is endemic,\" says \u003ca href=\"https://irp.nih.gov/pi/malcolm-martin\" target=\"_blank\" rel=\"noopener\">Malcolm Martin\u003c/a>, chief of the viral pathogenesis and viral section of the National Institute of Allergies and Infectious Diseases and a senior author of the paper. \"This is not a vaccine but a way to prevention.\"\u003c/p>\n\u003cp>\u003ca href=\"https://www.gatesfoundation.org/Who-We-Are/General-Information/Leadership/Global-Health/Emilio-Emini\" target=\"_blank\" rel=\"noopener\">Emilio Emini\u003c/a>, director of the Gates Foundation's HIV program, a funder of the new research, agrees the approach is worth pushing. \"The potential is there for the development of a neutralizing antibody cocktail that could be injected to provide many months of protection against HIV infection,\" Emini says. (The Gates Foundation is also a funder of NPR and this blog.)\u003c/p>\n\u003cp>Over the last few years, scientists have identified something like 100 of these anti-HIV antibodies, giving them plenty of opportunities to mix and match for maximum effectiveness.\u003c/p>\n\u003cp>The hope is that an injection of these antibodies every six to 12 months could protect large numbers of people from HIV in parts of the world where most infections are occurring. Currently 1.8 million people are newly infected with HIV every year. And other means of prevention, such as a daily pill containing anti-HIV drugs, have proved too cumbersome. \"Taking a pill every day can be just about impossible to do in a population of young people, even under the best of circumstances,\" Emini says.\u003c/p>\n\u003cp>And protecting that young population is key. \"In southern Africa, in particular, over the past 10 or 15 years there's been an explosion of young people,\" Emini says. \"In many of these countries the average age is in the 20s. Having the means to protect these young people is something that will be absolutely critical to controlling the epidemic.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The \u003cem>Nature Medicine \u003c/em>paper is just the latest report from a burgeoning new branch of HIV research that's gathering momentum.\u003c/p>\n\u003cp>\"This is not just about doing cool science — and this is cool science,\" says Mitchell Warren, executive director of \u003ca href=\"https://www.avac.org/\">AVAC\u003c/a>, a global HIV prevention advocacy group. \"People are excited about this antibody research as a whole new prevention approach. The long-term goal is still a vaccine. But in HIV prevention we will take what we can get.\"\u003c/p>\n\u003cp>But if you've been following AIDS, you might be wondering how antibodies from HIV-infected people could possibly protect against infection. After all, the hallmark of HIV infection is that immune defenses don't work.\u003c/p>\n\u003cp>The answer is that researchers are using antibodies derived from a tiny fraction of HIV-infected people — about 1 percent — called \"elite controllers\" or (the term Martin prefers) \"elite neutralizers.\" As his term indicates, these \"elite\" patients make antibodies that can neutralize, or kill, HIV. The patients typically have low levels of the virus and can live longer without virus-suppressing drugs before they get symptoms of immune system collapse, or AIDS.\u003c/p>\n\u003cp>Ultimately, most elite neutralizers do progress to AIDS if they don't take antiviral drugs. The reason, Martin says, is that during the initial stages of their HIV infection, their immune system \"takes a major hit from which it never recovers.\" That allows HIV to establish hideaways, or reservoirs, in the body. By the time their immune systems start generating antibodies to neutralize HIV, Martin says, \"it's too late\" to keep the infection under control forever. The horse is out of the barn.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>In the new work and \u003ca href=\"https://www.npr.org/sections/health-shots/2013/10/31/242093426/aids-scientists-encouraged-by-antibodies-that-hit-monkey-virus)\">previous experiments\u003c/a>, Martin and colleagues have identified the particular antibodies from these rare patients that can prevent HIV infection in the test tube. They then harvest these antibodies from patients and test them in monkeys to see if they prevent HIV infection from getting established in the first place. They've also learned to tweak the antibodies, introducing mutations that extend their lifetime in the bloodstream. And they've found that passive immunization works best when they combine two types of antibodies in one injection.\u003c/p>\n\u003cp>Two other findings improve the prospects that passive immunization may work in the real world:\u003c/p>\n\u003cul>\n\u003cli>It can be given by subcutaneous injections — a simple jab just under the skin — a much simpler and cheaper maneuver than the intravenous infusions used in earlier studies.\u003c/li>\n\u003cli>Small doses — three times lower than earlier IV doses — were enough to give many months of protection. That will bring the cost down too.\u003c/li>\n\u003c/ul>\n\u003cp>These elements \"make this report very important,\" Emini says. \"Everything is moving in the right direction.\"\u003c/p>\n\u003cp>Martin says another promising factor is the likelihood that the injected antibodies will stick around longer in humans' bloodstream than they do in monkeys' – thus offering more durable protection.\u003c/p>\n\u003cp>That's because a monkey's immune system recognizes the human-derived antibodies as foreign and so generate antibodies against the antibodies, clearing them from the blood. In studies when humans have been injected with these antibodies, Martin says, \"so far, there has been no report of humans ever developing anti-antibodies. So it's very likely, though we don't have proof of this, that these antibodies will last longer when we give them to humans.\"\u003c/p>\n\u003cp>The antibody cocktail researchers envision would contain neutralizing antibodies directed at multiple parts of the HIV outer coat. That would work against various strains of HIV circulating around the world and reduce the risk the virus would develop resistance.\u003c/p>\n\u003cp>Still, genetically engineered antibodies \"are actually quite expensive to produce,\" Emini acknowledges. \"So we need to develop ways to produce them at cost levels that are realistic for countries where most of the infection still occurs.\" The Gates Foundation's target price is no more than $150 per person per year — an amount comparable to the cost of HIV drug treatments now \u003ca href=\"https://www.npr.org/sections/health-shots/2013/10/31/242093426/aids-scientists-encouraged-by-antibodies-that-hit-monkey-virus)\">reaching 21 million people a year\u003c/a>.\u003c/p>\n\u003cp>Momentum behind the passive immunization against HIV is \u003c/p>\u003cp>\u003c/p>\u003cp>growing. \u003ca href=\"https://www.avac.org/trial-search?field_prevention_option_tid%5B%5D=1&keys=&title=&field_status_value=Ongoing&field_phase_value=All\">Eight human studies are underway\u003c/a> using the approach.\u003c/p>\n\u003cp>Two of them are enrolling a total of 5,000 people at risk of HIV infection — men who have sex with men in the United States, Latin America and South Africa, and women in seven African countries.\u003c/p>\n\u003cp>Those trials are using one of the first of the 100 anti-HIV antibodies to be discovered, called VRC01. But it has to be delivered every two months in 45-minute intravenous infusions. So even if that's shown to be effective in preventing HIV infections, it's not going to be practical as a real-world prevention strategy.\u003c/p>\n\u003cp>The two-antibody combination in the new report might be. It's being injected into humans in a small study that began last August. It's designed to see if any adverse effects arise, but it can also yield useful data on how long the antibody persists in humans and whether humans mount an immune defense against them.\u003c/p>\n\u003cp>Even though the monkey studies and human trials are preliminary, there's a sense of urgency behind the passive-immunization approach. Despite surprising success in getting anti-HIV treatment to infected people in most-affected nations, nobody thinks the world can treat its way out of the HIV pandemic.\u003c/p>\n\u003cp>\"The concern is that if we don't control the pandemic, 15 or 20 years from now we'll have more people with HIV in southern Africa than we had 15 years ago,\" Emini says. \"So the urgency remains very strong, and getting stronger.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Richard Knox is a New Hampshire-based health and science reporter, former NPR science correspondent and currently senior correspondent for WBUR in Boston. He's been reporting on HIV/AIDS since the beginning of the epidemic. Contact him @DickKnox\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Chasing+A+New+Way+To+Prevent+HIV%3A+Passive+Immunization&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/440869/chasing-a-new-way-to-prevent-hiv-passive-immunization","authors":["byline_futureofyou_440869"],"categories":["futureofyou_1062","futureofyou_1"],"tags":["futureofyou_650","futureofyou_141","futureofyou_61","futureofyou_651","futureofyou_1056"],"collections":["futureofyou_1097"],"featImg":"futureofyou_440870","label":"source_futureofyou_440869"},"futureofyou_437567":{"type":"posts","id":"futureofyou_437567","meta":{"index":"posts_1591205157","site":"futureofyou","id":"437567","score":null,"sort":[1513112415000]},"guestAuthors":[],"slug":"frontiers-of-hiv-research-the-man-who-was-nearly-cured","title":"The Man Who Was Nearly Cured of HIV","publishDate":1513112415,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>The cases of Clark Hawley, 54, and Luis Canales, 31, presented at the \u003ca href=\"http://www.curecountdown.org/research-index/2017/9/12/2017-hiv-cure-summit\" target=\"_blank\" rel=\"noopener\">amfAR HIV Cure Summit \u003c/a>in San Francisco last November, provided at least a temporary answer to a big question: Can very early treatment after exposure to HIV lead to complete eradication of the virus — an actual cure?\u003c/p>\n\u003cp>No.\u003c/p>\n\u003cp>But almost.\u003c/p>\n\u003caside class=\"pullquote alignright\">Early antitretroviral treatment brings about a striking period of long-term remission, also called a 'functional cure,' in an HIV patient. \u003c/aside>\n\u003cp>In Hawley’s case, nearly immediate treatment did usher in a striking period of long-term remission, also called a \"functional cure,\" in which zero trace of HIV was detected in his blood or tissue samples, without the benefit of drugs.\u003c/p>\n\u003cp>The men were recruited as part of an ongoing observational UCSF study. Both were given an initial dose of the antiretroviral combination Truvada, also known as pre-exposure prophylaxis, or PrEP, within two weeks after their suspected exposure to the virus. The treatment came so soon after infection that their immune systems had yet to generate an antibody response. In Hawley’s case, only a more sensitive genetic test called PCR, which measures an individual’s \u003ca href=\"https://www.aidsmap.com/Viral-load/page/1327496/\" target=\"_blank\" rel=\"noopener\">viral load\u003c/a>, showed signs of HIV. After the initial treatment, both men were switched to a daily four-drug antiviral regimen, which drove the virus below detectable levels.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>What happened next is a mystery.\u003c/p>\n\u003cp>[contextly_sidebar id=\"6nfWarjopr6zyonYcblrTOe4VSljxsdZ\"]As reported Nov. 7 in \u003cem> \u003ca href=\"https://protect-us.mimecast.com/s/8JwmB0iVvmacp?domain=journals.plos.org\" target=\"_blank\" rel=\"noopener\">PloS Medicine\u003c/a>\u003c/em>, a UCSF team led by Drs. Timothy Henrich and Steven Deeks said it failed to detect any trace of HIV in Hawley’s blood or tissue for the two years he remained on medication. Typically individuals on successful HIV therapy are classified as “undetectable” when drugs drive viral activity below observable levels in the blood. But it’s known that a small amount of residual virus called the HIV reservoir may be found in tissue using sensitive PCR tests. These came up negative.\u003c/p>\n\u003cp>Hawley then went off the drugs, a step that was part of the study design. About seven months later, the virus rebounded, quickly multiplying into an active infection. He immediately resumed antiretroviral treatment, which again rendered the virus undetectable.\u003c/p>\n\u003cfigure id=\"attachment_437571\" class=\"wp-caption alignright\" style=\"max-width: 1000px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/12/deeks-and-volberding.jpg\">\u003cimg class=\"wp-image-437571 size-full\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/12/deeks-and-volberding.jpg\" alt=\"\" width=\"1000\" height=\"754\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/12/deeks-and-volberding.jpg 1000w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/deeks-and-volberding-160x121.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/deeks-and-volberding-800x603.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/deeks-and-volberding-768x579.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/deeks-and-volberding-960x724.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/deeks-and-volberding-240x181.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/deeks-and-volberding-375x283.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/deeks-and-volberding-520x392.jpg 520w\" sizes=\"(max-width: 1000px) 100vw, 1000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Steven Deeks, right, who talked about the results of early intervention after exposure to the HIV virus, at amfAR's 2017 HIV Cure Summit. On the left is long-time HIV researcher Dr. Paul Volberding. \u003ccite>(amfAR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But what puzzled scientists was that his body still showed no sign of an antibody response. That suggested his immune system had never had sufficient time to generate a defense because the drugs had worked so quickly that they halted the initial infection. Yet, they knew he still had HIV from the results of a viral load test. More genetic tests confirmed the resuscitated virus was the same strain he was initially exposed to.\u003c/p>\n\u003caside class=\"pullquote alignright\">'We got close; we may have been off by a day or two.'\u003ccite>Dr. Steven Deeks, UCSF\u003c/cite>\u003c/aside>\n\u003cp>Deeks said Hawley probably has a small latent reservoir of HIV somewhere in his body, which hasn’t grown due to Truvada’s suppression of the virus’s initial spread. His status is now in a kind of limbo, somewhere between having HIV and not.\u003c/p>\n\u003cp>“The whole excitement around Clark is that we were able to initiate therapy so early that we were hoping to prevent the establishing of latency,” says Deeks. “But it did not happen. We got close; we may have been off by a day or two. We did not achieve a real cure.”\u003c/p>\n\u003cp>Even if Hawley had been permanently freed of HIV, the problem with any protocol based on such early treatment is that doctors rarely detect a patient’s infection in the first days after exposure. Rather, the case is significant due to the milestone of pushing a patient into long-term remission free of medication, and because it might offer new clues on how to induce a permanent state of HIV dormancy.\u003c/p>\n\u003cp>\u003cstrong>Dramatically Reducing HIV Reservoirs\u003c/strong>\u003c/p>\n\u003cp>Canales’ case is also tantalizing. He was given a PrEP dose of Truvada 12 days after exposure, and for two years showed no sign of HIV in blood or tissue samples on both viral load and PCR tests. Because of Hawley’s relapse experience after stopping therapy, doctors kept him on the treatment. The only way they could detect signs of the virus in Canales was by transferring some of his cells into mice bred with a copycat human immune system. They were able to intermittently spy a virus particle here or there upon removing the cells from the mice. As with Hawley, early treatment had dramatically limited the amount of virus that would later coalesce into a dormant pool in his body.\u003c/p>\n\u003cp>“I think we have proven to ourselves that early treatment will never be curative,” Deeks said, referring to complete eradication of the virus within someone’s body. When pressed whether he really meant “never,” he amended his answer: “No, not yet.”\u003c/p>\n\u003cp>“But we can definitely shift the balance in favor of the patient,” he went on, “because the reservoir is reduced a hundred- to a million-fold.”\u003c/p>\n\u003cp>Deeks and his team are now investigating a series of HIV vaccines aimed at providing an immune booster to control the pieces of virus that remain in a patient’s body, the final step in sending HIV patients into remission — no medication required. Beyond that, if such tools could wipe out the last pockets of HIV, medical science would have finally achieved its ultimate goal in the fight against AIDS — an actual cure.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Anne-christine d’Adesky is a longtime chronicler of HIV research. Her 90s-era AIDS memoir, “The Pox Lover,” was published in June.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Clark Hawley is a patient whose HIV went into long-term remission, also known as a 'functional cure,' after receiving very early antiretroviral treatment.","status":"publish","parent":0,"modified":1518461043,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":20,"wordCount":983},"headData":{"title":"The Man Who Was Nearly Cured of HIV | KQED","description":"Clark Hawley is a patient whose HIV went into long-term remission, also known as a 'functional cure,' after receiving very early antiretroviral treatment.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"437567 https://ww2.kqed.org/futureofyou/?p=437567","disqusUrl":"https://ww2.kqed.org/futureofyou/2017/12/12/frontiers-of-hiv-research-the-man-who-was-nearly-cured/","disqusTitle":"The Man Who Was Nearly Cured of HIV","source":"KQED Future of You","nprByline":"Anne-christine d'Adesky\u003cbr />KQED Future of You","path":"/futureofyou/437567/frontiers-of-hiv-research-the-man-who-was-nearly-cured","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The cases of Clark Hawley, 54, and Luis Canales, 31, presented at the \u003ca href=\"http://www.curecountdown.org/research-index/2017/9/12/2017-hiv-cure-summit\" target=\"_blank\" rel=\"noopener\">amfAR HIV Cure Summit \u003c/a>in San Francisco last November, provided at least a temporary answer to a big question: Can very early treatment after exposure to HIV lead to complete eradication of the virus — an actual cure?\u003c/p>\n\u003cp>No.\u003c/p>\n\u003cp>But almost.\u003c/p>\n\u003caside class=\"pullquote alignright\">Early antitretroviral treatment brings about a striking period of long-term remission, also called a 'functional cure,' in an HIV patient. \u003c/aside>\n\u003cp>In Hawley’s case, nearly immediate treatment did usher in a striking period of long-term remission, also called a \"functional cure,\" in which zero trace of HIV was detected in his blood or tissue samples, without the benefit of drugs.\u003c/p>\n\u003cp>The men were recruited as part of an ongoing observational UCSF study. Both were given an initial dose of the antiretroviral combination Truvada, also known as pre-exposure prophylaxis, or PrEP, within two weeks after their suspected exposure to the virus. The treatment came so soon after infection that their immune systems had yet to generate an antibody response. In Hawley’s case, only a more sensitive genetic test called PCR, which measures an individual’s \u003ca href=\"https://www.aidsmap.com/Viral-load/page/1327496/\" target=\"_blank\" rel=\"noopener\">viral load\u003c/a>, showed signs of HIV. After the initial treatment, both men were switched to a daily four-drug antiviral regimen, which drove the virus below detectable levels.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>What happened next is a mystery.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>As reported Nov. 7 in \u003cem> \u003ca href=\"https://protect-us.mimecast.com/s/8JwmB0iVvmacp?domain=journals.plos.org\" target=\"_blank\" rel=\"noopener\">PloS Medicine\u003c/a>\u003c/em>, a UCSF team led by Drs. Timothy Henrich and Steven Deeks said it failed to detect any trace of HIV in Hawley’s blood or tissue for the two years he remained on medication. Typically individuals on successful HIV therapy are classified as “undetectable” when drugs drive viral activity below observable levels in the blood. But it’s known that a small amount of residual virus called the HIV reservoir may be found in tissue using sensitive PCR tests. These came up negative.\u003c/p>\n\u003cp>Hawley then went off the drugs, a step that was part of the study design. About seven months later, the virus rebounded, quickly multiplying into an active infection. He immediately resumed antiretroviral treatment, which again rendered the virus undetectable.\u003c/p>\n\u003cfigure id=\"attachment_437571\" class=\"wp-caption alignright\" style=\"max-width: 1000px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/12/deeks-and-volberding.jpg\">\u003cimg class=\"wp-image-437571 size-full\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/12/deeks-and-volberding.jpg\" alt=\"\" width=\"1000\" height=\"754\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/12/deeks-and-volberding.jpg 1000w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/deeks-and-volberding-160x121.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/deeks-and-volberding-800x603.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/deeks-and-volberding-768x579.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/deeks-and-volberding-960x724.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/deeks-and-volberding-240x181.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/deeks-and-volberding-375x283.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2017/12/deeks-and-volberding-520x392.jpg 520w\" sizes=\"(max-width: 1000px) 100vw, 1000px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Dr. Steven Deeks, right, who talked about the results of early intervention after exposure to the HIV virus, at amfAR's 2017 HIV Cure Summit. On the left is long-time HIV researcher Dr. Paul Volberding. \u003ccite>(amfAR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>But what puzzled scientists was that his body still showed no sign of an antibody response. That suggested his immune system had never had sufficient time to generate a defense because the drugs had worked so quickly that they halted the initial infection. Yet, they knew he still had HIV from the results of a viral load test. More genetic tests confirmed the resuscitated virus was the same strain he was initially exposed to.\u003c/p>\n\u003caside class=\"pullquote alignright\">'We got close; we may have been off by a day or two.'\u003ccite>Dr. Steven Deeks, UCSF\u003c/cite>\u003c/aside>\n\u003cp>Deeks said Hawley probably has a small latent reservoir of HIV somewhere in his body, which hasn’t grown due to Truvada’s suppression of the virus’s initial spread. His status is now in a kind of limbo, somewhere between having HIV and not.\u003c/p>\n\u003cp>“The whole excitement around Clark is that we were able to initiate therapy so early that we were hoping to prevent the establishing of latency,” says Deeks. “But it did not happen. We got close; we may have been off by a day or two. We did not achieve a real cure.”\u003c/p>\n\u003cp>Even if Hawley had been permanently freed of HIV, the problem with any protocol based on such early treatment is that doctors rarely detect a patient’s infection in the first days after exposure. Rather, the case is significant due to the milestone of pushing a patient into long-term remission free of medication, and because it might offer new clues on how to induce a permanent state of HIV dormancy.\u003c/p>\n\u003cp>\u003cstrong>Dramatically Reducing HIV Reservoirs\u003c/strong>\u003c/p>\n\u003cp>Canales’ case is also tantalizing. He was given a PrEP dose of Truvada 12 days after exposure, and for two years showed no sign of HIV in blood or tissue samples on both viral load and PCR tests. Because of Hawley’s relapse experience after stopping therapy, doctors kept him on the treatment. The only way they could detect signs of the virus in Canales was by transferring some of his cells into mice bred with a copycat human immune system. They were able to intermittently spy a virus particle here or there upon removing the cells from the mice. As with Hawley, early treatment had dramatically limited the amount of virus that would later coalesce into a dormant pool in his body.\u003c/p>\n\u003cp>“I think we have proven to ourselves that early treatment will never be curative,” Deeks said, referring to complete eradication of the virus within someone’s body. When pressed whether he really meant “never,” he amended his answer: “No, not yet.”\u003c/p>\n\u003cp>“But we can definitely shift the balance in favor of the patient,” he went on, “because the reservoir is reduced a hundred- to a million-fold.”\u003c/p>\n\u003cp>Deeks and his team are now investigating a series of HIV vaccines aimed at providing an immune booster to control the pieces of virus that remain in a patient’s body, the final step in sending HIV patients into remission — no medication required. Beyond that, if such tools could wipe out the last pockets of HIV, medical science would have finally achieved its ultimate goal in the fight against AIDS — an actual cure.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Anne-christine d’Adesky is a longtime chronicler of HIV research. Her 90s-era AIDS memoir, “The Pox Lover,” was published in June.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/437567/frontiers-of-hiv-research-the-man-who-was-nearly-cured","authors":["byline_futureofyou_437567"],"categories":["futureofyou_452","futureofyou_1062","futureofyou_1","futureofyou_73"],"tags":["futureofyou_650","futureofyou_1275","futureofyou_651"],"featImg":"futureofyou_437568","label":"source_futureofyou_437567"},"futureofyou_435658":{"type":"posts","id":"futureofyou_435658","meta":{"index":"posts_1591205157","site":"futureofyou","id":"435658","score":null,"sort":[1506621769000]},"guestAuthors":[],"slug":"research-dampens-hopes-of-hiv-cure-shows-progress-on-remission-without-drugs","title":"Research Dampens Hopes of HIV Cure, Shows Progress on Remission Without Drugs","publishDate":1506621769,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>In 2016, hopes ran high that an HIV cure may be just around the corner. An experimental approach known as “shock and kill” seemed \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/12/17/new-hiv-studies-offer-fresh-hope-for-a-cure/\" target=\"_blank\" rel=\"noopener\">promising\u003c/a>. That treatment takes aim at dormant, undetected traces of the virus lingering within immune cells.\u003c/p>\n\u003cp>In recent months, however, those hopes have dampened.\u003c/p>\n\u003caside class=\"pullquote alignright\">'We are starting to see that control in an [antiretroviral-drug-free] system is attainable. I think that’s a more realistic goal to pursue, one that can benefit millions of people now living with this disease. For now, a cure is still proving elusive.'\u003ccite>Anthony Fauci, National Institute of Allergy and Infectious Diseases\u003c/cite>\u003c/aside>\n\u003cp>While shock and kill can effectively flush HIV from its hiding places in tissue reservoirs, some virus particles may still remain, new research shows. Now researchers are investigating why, in the hopes that the answer will point, if not to a cure, than at least to therapies that will ensure the long-term health of patients.\u003c/p>\n\u003cp>In March, scientists from the lab of veteran HIV-hunter Dr. Robert Siliciano published \u003ca href=\"http://jem.rupress.org/content/214/4/959\" target=\"_blank\" rel=\"noopener\">research \u003c/a>showing that dormant T cells harboring HIV particles will spread through cell division. The discovery was a surprise, because researchers long assumed such cells were inactive. By using a new DNA mapping technique, the Siliciano team found identical HIV fragments, called proviruses, in daughter T-cells.\u003c/p>\n\u003cp>“We knew before that the [HIV]reservoir is very long-lived,” said Siliciano\u003cstrong> \u003c/strong>in a \u003ca href=\"https://hub.jhu.edu/2017/05/31/hiv-aids-cure-latent-reservoirs/\">press release\u003c/a>. “Now it is clear that these cells aren't just sitting there but are dividing and replenishing themselves.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The standard tests that measure HIV replication, called viral load tests, aren’t sensitive enough to detect such stealth viral spread. Siliciano cautioned that even though the HIV pool may be tiny — a dormant virus particle here or there — it could, at least theoretically, retrigger an active HIV infection.\u003c/p>\n\u003cp>This sobering news has caused leading scientists to reconsider the challenge of eradicating every last trace of HIV in the body, the definition of a full cure. That task now seems much more daunting.\u003c/p>\n\u003cp>In a recent review of research on an AIDS cure, Dr. Anthony Fauci, head of the National Institutes of Allergy and Infectious Diseases, was characteristically blunt in assessing the challenges ahead. At this year's International AIDS Conference, held this July in Paris, he told an audience that a cure, though still a worthy goal, was “difficult to impossible.”\u003c/p>\n\u003cp>While antiretroviral, or ART, medication has significantly\u003ca href=\"http://www.bbc.com/news/health-39872530\" target=\"_blank\" rel=\"noopener\"> prolonged the lives\u003c/a> of those infected with HIV, the treatment is still out of reach to many globally. In addition, the drugs have side effects, and long-term health impacts for those in treatment are still unclear. A cure would also eliminate any fear of passing on the virus or seeing HIV bounce back.\u003c/p>\n\u003cp>The new developments do not mean that shock and kill is dead. However, the strategy may need to be combined with different approaches and weapons to eradicate the silent HIV pool. Already, new therapies, called \"lock and block,\" are being tried to prevent any viral escape from the reservoir to reduce risk of reinfection.\u003c/p>\n\u003cp>\u003cstrong>New Target in Sight: Long-Term Remission Without Drugs\u003c/strong>\u003c/p>\n\u003cp>In the meantime, Fauci was more excited by promising studies pointing to long-term remission without drugs as a viable treatment plan. A growing body of data shows that some people who initially take ART drugs and later go off them can remain healthy for months and even years. When these patients are tested for HIV infection, their viral load -- a measure of active infection -- is below detectable levels. This has led to the rise of new buzzwords in AIDS circles: “ART-free remission.”\u003c/p>\n\u003caside class=\"pullquote alignright\">'We knew before that the [HIV] reservoir is very long-lived. Now it is clear that these cells aren't just sitting there but are dividing and replenishing themselves.'\u003ccite>Robert Siliciano, Johns Hopkins University\u003c/cite>\u003c/aside>\n\u003cp>\"We are starting to see that control in an ART-free system is attainable,” said Fauci. “I think that’s a more realistic goal to pursue, one that can benefit millions of people now living with this disease. For now, a cure is still proving elusive.”\u003c/p>\n\u003cp>At this year’s International AIDS Conference, most media coverage focused on cases in which antiretroviral treatment has been interrupted with good results. One attention-grabbing study featured a South African child who appeared \u003ca href=\"http://programme.ias2017.org/Abstract/Abstract/5836\" target=\"_blank\" rel=\"noopener\">HIV-free\u003c/a> eight-and-a-half years after stopping medication.\u003c/p>\n\u003cp>Such long-term remission is not unheard of. Earlier studies have reported on a French teenager whose HIV viral load levels remain undetectable after 11 years. Other work has followed a subset of patients whose infection levels are similarly undetectable after more than four years. These cases were observed in studies; it's unknown how much they reflect what's happening in terms of larger populations. Shock and kill studies have found a wide range of viral rebound times in patients who go off ART.\u003c/p>\n\u003cp>In his AIDS conference roundup of cure research, Fauci noted that in studies where patients discontinue treatment, the average time for HIV to rebound has already more than doubled. Up until 2000, the virus reappeared within 7 to 14 days of a patient going off medication. Since that time through 2015, the average was 28 days. That’s due in part to better drugs, Fauci said. The increases may also be driven by patients receiving treatment soon after exposure to HIV, which may help maintain stronger immune systems.\u003c/p>\n\u003cp>“Every lab has a few patients who have a great deal of variability to time they rebound,” Fauci said. \"It may be two weeks in some people, or three months, or many months. What we are seeing is, tucked away in there, that people treated with good drugs could stop therapy and go for an extended time” without HIV coming back.\u003c/p>\n\u003cp>To Fauci, this pattern of increasing remission times, as we move through the third decade of AIDS, is an important finding. It may not be as sexy or definitive as attaining a cure, but remission without drugs would represent a welcome sea change for the 36.7 million people living with HIV, including the \u003ca href=\"http://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2016/november/20161121_PR_get-on-the-fast-track\" target=\"_blank\" rel=\"noopener\">18 million\u003c/a> on daily ART pills.\u003c/p>\n\u003cp>Fauci's also excited about a monkey antibody, alpha4beta7, which has a close human equivalent: the FDA-approved drug vedolizumab that is used to treat Crohn's disease and ulcerative colitis. Fauci's team saw \"sustained remission\" in macaques which had been given the monkey antibody and which had been infected with a simian sister virus to HIV.\u003c/p>\n\u003cp>Fauci's lab is now completing a short study of vedolizumab plus ART in 17 patients and expects results by the end of October.\u003c/p>\n\u003cp>\u003cstrong>'The Devil You Know'\u003c/strong>\u003c/p>\n\u003cp>Many HIV/AIDS advocacy groups remain focused on cure research, and are grappling with the newly discovered impediments to shock and kill. All the same, remission without drugs is still a hot topic.\u003c/p>\n\u003cp>“I think a lot of people would like a remission,” said Jessica Salzwedel, who works in community literacy at the AIDS Vaccine Advocacy Coalition in New York.\u003c/p>\n\u003cp>She’s also seen a lot of excitement about long-acting injectable therapies, in which ART drugs are administered in a shot that can last four or eight weeks, instead of the regimen of daily pills patients now take.\u003c/p>\n\u003cp>Salzwedel feels people on ART may prefer the certainty of knowing HIV is being controlled rather than the question mark of going off ART during a research trial and waiting to see if the virus bounces back. For now, “It’s the devil you know versus the devil you don’t. Some people would rather live with a pill and know they are virally controlled.”\u003c/p>\n\u003cp>“We have to explore all avenues,\" summed up Fauci. \"But I think remission is a very viable way to go.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cem>Anne-christine d'Adesky is a longtime chronicler of HIV research. Her 90s-era AIDS memoir, \"The Pox Lover,\" was published in June.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Last year hopes ran high an HIV cure may be near, but recent research has presented new stumbling blocks. Meanwhile, a positive trend: Relapse times have lengthened for those who stop taking medication.","status":"publish","parent":0,"modified":1506714251,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":29,"wordCount":1352},"headData":{"title":"Research Dampens Hopes of HIV Cure, Shows Progress on Remission Without Drugs | KQED","description":"Last year hopes ran high an HIV cure may be near, but recent research has presented new stumbling blocks. Meanwhile, a positive trend: Relapse times have lengthened for those who stop taking medication.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"435658 https://ww2.kqed.org/futureofyou/?p=435658","disqusUrl":"https://ww2.kqed.org/futureofyou/2017/09/28/research-dampens-hopes-of-hiv-cure-shows-progress-on-remission-without-drugs/","disqusTitle":"Research Dampens Hopes of HIV Cure, Shows Progress on Remission Without Drugs","nprByline":"Anne-christine d'Adesky\u003cbr />Future of You","path":"/futureofyou/435658/research-dampens-hopes-of-hiv-cure-shows-progress-on-remission-without-drugs","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>In 2016, hopes ran high that an HIV cure may be just around the corner. An experimental approach known as “shock and kill” seemed \u003ca href=\"https://ww2.kqed.org/futureofyou/2016/12/17/new-hiv-studies-offer-fresh-hope-for-a-cure/\" target=\"_blank\" rel=\"noopener\">promising\u003c/a>. That treatment takes aim at dormant, undetected traces of the virus lingering within immune cells.\u003c/p>\n\u003cp>In recent months, however, those hopes have dampened.\u003c/p>\n\u003caside class=\"pullquote alignright\">'We are starting to see that control in an [antiretroviral-drug-free] system is attainable. I think that’s a more realistic goal to pursue, one that can benefit millions of people now living with this disease. For now, a cure is still proving elusive.'\u003ccite>Anthony Fauci, National Institute of Allergy and Infectious Diseases\u003c/cite>\u003c/aside>\n\u003cp>While shock and kill can effectively flush HIV from its hiding places in tissue reservoirs, some virus particles may still remain, new research shows. Now researchers are investigating why, in the hopes that the answer will point, if not to a cure, than at least to therapies that will ensure the long-term health of patients.\u003c/p>\n\u003cp>In March, scientists from the lab of veteran HIV-hunter Dr. Robert Siliciano published \u003ca href=\"http://jem.rupress.org/content/214/4/959\" target=\"_blank\" rel=\"noopener\">research \u003c/a>showing that dormant T cells harboring HIV particles will spread through cell division. The discovery was a surprise, because researchers long assumed such cells were inactive. By using a new DNA mapping technique, the Siliciano team found identical HIV fragments, called proviruses, in daughter T-cells.\u003c/p>\n\u003cp>“We knew before that the [HIV]reservoir is very long-lived,” said Siliciano\u003cstrong> \u003c/strong>in a \u003ca href=\"https://hub.jhu.edu/2017/05/31/hiv-aids-cure-latent-reservoirs/\">press release\u003c/a>. “Now it is clear that these cells aren't just sitting there but are dividing and replenishing themselves.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The standard tests that measure HIV replication, called viral load tests, aren’t sensitive enough to detect such stealth viral spread. Siliciano cautioned that even though the HIV pool may be tiny — a dormant virus particle here or there — it could, at least theoretically, retrigger an active HIV infection.\u003c/p>\n\u003cp>This sobering news has caused leading scientists to reconsider the challenge of eradicating every last trace of HIV in the body, the definition of a full cure. That task now seems much more daunting.\u003c/p>\n\u003cp>In a recent review of research on an AIDS cure, Dr. Anthony Fauci, head of the National Institutes of Allergy and Infectious Diseases, was characteristically blunt in assessing the challenges ahead. At this year's International AIDS Conference, held this July in Paris, he told an audience that a cure, though still a worthy goal, was “difficult to impossible.”\u003c/p>\n\u003cp>While antiretroviral, or ART, medication has significantly\u003ca href=\"http://www.bbc.com/news/health-39872530\" target=\"_blank\" rel=\"noopener\"> prolonged the lives\u003c/a> of those infected with HIV, the treatment is still out of reach to many globally. In addition, the drugs have side effects, and long-term health impacts for those in treatment are still unclear. A cure would also eliminate any fear of passing on the virus or seeing HIV bounce back.\u003c/p>\n\u003cp>The new developments do not mean that shock and kill is dead. However, the strategy may need to be combined with different approaches and weapons to eradicate the silent HIV pool. Already, new therapies, called \"lock and block,\" are being tried to prevent any viral escape from the reservoir to reduce risk of reinfection.\u003c/p>\n\u003cp>\u003cstrong>New Target in Sight: Long-Term Remission Without Drugs\u003c/strong>\u003c/p>\n\u003cp>In the meantime, Fauci was more excited by promising studies pointing to long-term remission without drugs as a viable treatment plan. A growing body of data shows that some people who initially take ART drugs and later go off them can remain healthy for months and even years. When these patients are tested for HIV infection, their viral load -- a measure of active infection -- is below detectable levels. This has led to the rise of new buzzwords in AIDS circles: “ART-free remission.”\u003c/p>\n\u003caside class=\"pullquote alignright\">'We knew before that the [HIV] reservoir is very long-lived. Now it is clear that these cells aren't just sitting there but are dividing and replenishing themselves.'\u003ccite>Robert Siliciano, Johns Hopkins University\u003c/cite>\u003c/aside>\n\u003cp>\"We are starting to see that control in an ART-free system is attainable,” said Fauci. “I think that’s a more realistic goal to pursue, one that can benefit millions of people now living with this disease. For now, a cure is still proving elusive.”\u003c/p>\n\u003cp>At this year’s International AIDS Conference, most media coverage focused on cases in which antiretroviral treatment has been interrupted with good results. One attention-grabbing study featured a South African child who appeared \u003ca href=\"http://programme.ias2017.org/Abstract/Abstract/5836\" target=\"_blank\" rel=\"noopener\">HIV-free\u003c/a> eight-and-a-half years after stopping medication.\u003c/p>\n\u003cp>Such long-term remission is not unheard of. Earlier studies have reported on a French teenager whose HIV viral load levels remain undetectable after 11 years. Other work has followed a subset of patients whose infection levels are similarly undetectable after more than four years. These cases were observed in studies; it's unknown how much they reflect what's happening in terms of larger populations. Shock and kill studies have found a wide range of viral rebound times in patients who go off ART.\u003c/p>\n\u003cp>In his AIDS conference roundup of cure research, Fauci noted that in studies where patients discontinue treatment, the average time for HIV to rebound has already more than doubled. Up until 2000, the virus reappeared within 7 to 14 days of a patient going off medication. Since that time through 2015, the average was 28 days. That’s due in part to better drugs, Fauci said. The increases may also be driven by patients receiving treatment soon after exposure to HIV, which may help maintain stronger immune systems.\u003c/p>\n\u003cp>“Every lab has a few patients who have a great deal of variability to time they rebound,” Fauci said. \"It may be two weeks in some people, or three months, or many months. What we are seeing is, tucked away in there, that people treated with good drugs could stop therapy and go for an extended time” without HIV coming back.\u003c/p>\n\u003cp>To Fauci, this pattern of increasing remission times, as we move through the third decade of AIDS, is an important finding. It may not be as sexy or definitive as attaining a cure, but remission without drugs would represent a welcome sea change for the 36.7 million people living with HIV, including the \u003ca href=\"http://www.unaids.org/en/resources/presscentre/pressreleaseandstatementarchive/2016/november/20161121_PR_get-on-the-fast-track\" target=\"_blank\" rel=\"noopener\">18 million\u003c/a> on daily ART pills.\u003c/p>\n\u003cp>Fauci's also excited about a monkey antibody, alpha4beta7, which has a close human equivalent: the FDA-approved drug vedolizumab that is used to treat Crohn's disease and ulcerative colitis. Fauci's team saw \"sustained remission\" in macaques which had been given the monkey antibody and which had been infected with a simian sister virus to HIV.\u003c/p>\n\u003cp>Fauci's lab is now completing a short study of vedolizumab plus ART in 17 patients and expects results by the end of October.\u003c/p>\n\u003cp>\u003cstrong>'The Devil You Know'\u003c/strong>\u003c/p>\n\u003cp>Many HIV/AIDS advocacy groups remain focused on cure research, and are grappling with the newly discovered impediments to shock and kill. All the same, remission without drugs is still a hot topic.\u003c/p>\n\u003cp>“I think a lot of people would like a remission,” said Jessica Salzwedel, who works in community literacy at the AIDS Vaccine Advocacy Coalition in New York.\u003c/p>\n\u003cp>She’s also seen a lot of excitement about long-acting injectable therapies, in which ART drugs are administered in a shot that can last four or eight weeks, instead of the regimen of daily pills patients now take.\u003c/p>\n\u003cp>Salzwedel feels people on ART may prefer the certainty of knowing HIV is being controlled rather than the question mark of going off ART during a research trial and waiting to see if the virus bounces back. For now, “It’s the devil you know versus the devil you don’t. Some people would rather live with a pill and know they are virally controlled.”\u003c/p>\n\u003cp>“We have to explore all avenues,\" summed up Fauci. \"But I think remission is a very viable way to go.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cem>Anne-christine d'Adesky is a longtime chronicler of HIV research. Her 90s-era AIDS memoir, \"The Pox Lover,\" was published in June.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/435658/research-dampens-hopes-of-hiv-cure-shows-progress-on-remission-without-drugs","authors":["byline_futureofyou_435658"],"categories":["futureofyou_1062","futureofyou_1"],"tags":["futureofyou_650","futureofyou_1364","futureofyou_1275","futureofyou_651","futureofyou_1365","futureofyou_1145"],"featImg":"futureofyou_435681","label":"futureofyou"},"futureofyou_379387":{"type":"posts","id":"futureofyou_379387","meta":{"index":"posts_1591205157","site":"futureofyou","id":"379387","score":null,"sort":[1494276378000]},"guestAuthors":[],"slug":"aids-stigma-prompts-china-to-sell-hiv-tests-in-campus-vending-machines","title":"AIDS Stigma Prompts China to Sell HIV Tests in Campus Vending Machines","publishDate":1494276378,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>Vending machines are selling increasingly novel items: \u003ca href=\"http://sprinkles.com/cupcake-atm\">cupcakes\u003c/a>, \u003ca href=\"https://www.theatlantic.com/china/archive/2013/09/chinas-newest-innovation-live-crab-vending-machines/279650/\">live crabs\u003c/a> and \u003ca href=\"http://sf.eater.com/2016/7/29/12325912/baguette-vending-machine-castro-san-francisco\">fresh baguettes\u003c/a>.\u003c/p>\n\u003cp>In China, you can now add HIV testing kits to that list.\u003c/p>\n\u003cp>China is piloting the use of vending machines that sell HIV testing kits on university campuses. The goal is to reach students who may be reluctant to go to a clinic for a test because of the stigma of contracting HIV.\u003c/p>\n\u003cp>The experimental program began last year on five college campuses in the city of Beijing as well as Harbin, Guangxi and Heilongjiang provinces. Local media just recently publicized it. Users pay the equivalent of a little over $4 for a kit with a container for a urine sample that can be dropped off anonymously at a receptacle in the machine that dispenses the test. Users can check their results online in 10 to 15 days.\u003c/p>\n\u003cp>HIV/AIDS activists in China have lauded the vending machines as a positive step for encouraging more people to get tested.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"Helping people to run a test for themselves like a take-home pregnancy test would be very helpful,\" says Martin Yang, a program manager at the \u003ca href=\"https://www.thebeijinger.com/directory/beijing-gender-health-education-institute-bghei\">Beijing Gender Health Education Institute\u003c/a>, one of the first Chinese nongovernmental groups to focus on issues related to gender, sexuality and sexual health.\u003c/p>\n\u003cp>In China, homosexuality is still a taboo — listed as a mental illness until 2001, forbidden from film scenes. Because of its association with homosexuality, HIV/AIDS is effectively a taboo subject as well. Official data show around 654,000 people in the country live with HIV or AIDS, though researchers believe the actual number is likely higher.\u003c/p>\n\u003cp>Patients with HIV or AIDS say they are routinely turned away from hospitals and clinics when they seek care, despite regulations that explicitly forbid that kind of discrimination. Last July, phone scammers blackmailed hundreds of people with HIV or AIDS after obtaining their personal information through a data leak and threatening to reveal their identities if they didn't pay up.\u003c/p>\n\u003cp>That societal stigma has made promoting HIV/AIDS awareness and testing extremely difficult.\u003c/p>\n\u003cp>\"The most common psychological barriers given for not having HIV testing were perceived low risk of HIV infection and fears of being stigmatized for homosexuality,\" wrote the researchers for a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3076143/\">paper \u003c/a>on HIV/AIDS testing among \"MSM\" — men who have sex with men — who were migrants to Beijing from other parts of China.\u003c/p>\n\u003cp>So now Chinese health authorities are trying this vending machine tack to reach populations under 30, which experience higher rates of transmission than older age groups.\u003c/p>\n\u003cp>Such self-administered HIV tests are also available online. A search on Taobao, the Chinese e-commerce platform, turned up dozens of test brands costing around $15-$45 per kit. It was unclear how many had been approved by Chinese health authorities. Self-test kits operate in a gray area in China: The law states that the tests should be opened and used only in the presence of a medical professional.\u003c/p>\n\u003cp>The vending machine program is overseen by the \u003ca href=\"http://www.chinaaids.cn/english/aboutncaids/\">National Center for AIDS/STD Control and Prevention (NCAIDS)\u003c/a>, which, according to Chinese media reports, is subsidizing the cost to keep it at about $4. NCAIDS did not respond to a request for comment, citing a lengthy approval process before it could talk to foreign media.\u003c/p>\n\u003cp>Whether the vending machine tests will be used is still uncertain.\u003c/p>\n\u003cp>Local media reports say fewer than 10 kits have been sold at the Harbin Institute of Engineering, one of the campuses chosen for the pilot, since the vending machines came into use last November.\u003c/p>\n\u003cp>\"I think these kinds of method will yield some results but to what extent is still unclear. Right now, these vending machine test kits are not a significant channel for testing,\" says Liu Shi, program manager of the \u003ca href=\"http://www.chinaaidswalk.cn/\">China AIDS Walk\u003c/a> initiative.\u003c/p>\n\u003cp>Another challenge would be the time lapse between when a person contracts HIV and when they take a test, says Martin Yang of the Beijing Gender Health Education Institute. It can take up to several weeks for HIV to develop to a stage where it is detectable through a urine test.\u003c/p>\n\u003cp>But \u003ca href=\"http://www.jhsph.edu/faculty/directory/profile/53/chris-beyrer\">Dr. Chris Beyrer\u003c/a>, a professor at the Johns Hopkins Bloomberg School of Public Health, sees potential benefits. Beyrer, who is not involved in this vending machine program, notes in an email that \"there is always some window [of time]\" before a test will react to an infection. But he adds: \"The issue is that self-testing may reach people who are less likely to come into a clinic, so it may get to some people sooner in infection course and hopefully reduce onward transmission. So you have to look at this as ... the public health goal of getting people at risk to know their status, and for people at significant risk to regularize testing.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Emily Feng is a freelance journalist based in Beijing.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Why+China+Is+Selling+Cheap+HIV+Tests+In+Campus+Vending+Machines&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"It's a pilot project to reach youth who are at risk of infection — and reluctant to come to clinics because of the stigma around HIV/AIDS. Is anyone buying?","status":"publish","parent":0,"modified":1494276378,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":21,"wordCount":824},"headData":{"title":"AIDS Stigma Prompts China to Sell HIV Tests in Campus Vending Machines | KQED","description":"It's a pilot project to reach youth who are at risk of infection — and reluctant to come to clinics because of the stigma around HIV/AIDS. Is anyone buying?","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"379387 https://ww2.kqed.org/futureofyou/?p=379387","disqusUrl":"https://ww2.kqed.org/futureofyou/2017/05/08/aids-stigma-prompts-china-to-sell-hiv-tests-in-campus-vending-machines/","disqusTitle":"AIDS Stigma Prompts China to Sell HIV Tests in Campus Vending Machines","nprByline":"Emily Feng\u003cbr />NPR Goats and Soda","nprImageAgency":"Reuters","nprStoryId":"525380494","nprApiLink":"http://api.npr.org/query?id=525380494&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/goatsandsoda/2017/04/25/525380494/why-china-is-selling-cheap-hiv-tests-in-campus-vending-machines?ft=nprml&f=525380494","nprRetrievedStory":"1","nprPubDate":"Tue, 25 Apr 2017 14:24:00 -0400","nprStoryDate":"Tue, 25 Apr 2017 11:50:00 -0400","nprLastModifiedDate":"Tue, 25 Apr 2017 14:24:22 -0400","path":"/futureofyou/379387/aids-stigma-prompts-china-to-sell-hiv-tests-in-campus-vending-machines","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Vending machines are selling increasingly novel items: \u003ca href=\"http://sprinkles.com/cupcake-atm\">cupcakes\u003c/a>, \u003ca href=\"https://www.theatlantic.com/china/archive/2013/09/chinas-newest-innovation-live-crab-vending-machines/279650/\">live crabs\u003c/a> and \u003ca href=\"http://sf.eater.com/2016/7/29/12325912/baguette-vending-machine-castro-san-francisco\">fresh baguettes\u003c/a>.\u003c/p>\n\u003cp>In China, you can now add HIV testing kits to that list.\u003c/p>\n\u003cp>China is piloting the use of vending machines that sell HIV testing kits on university campuses. The goal is to reach students who may be reluctant to go to a clinic for a test because of the stigma of contracting HIV.\u003c/p>\n\u003cp>The experimental program began last year on five college campuses in the city of Beijing as well as Harbin, Guangxi and Heilongjiang provinces. Local media just recently publicized it. Users pay the equivalent of a little over $4 for a kit with a container for a urine sample that can be dropped off anonymously at a receptacle in the machine that dispenses the test. Users can check their results online in 10 to 15 days.\u003c/p>\n\u003cp>HIV/AIDS activists in China have lauded the vending machines as a positive step for encouraging more people to get tested.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Helping people to run a test for themselves like a take-home pregnancy test would be very helpful,\" says Martin Yang, a program manager at the \u003ca href=\"https://www.thebeijinger.com/directory/beijing-gender-health-education-institute-bghei\">Beijing Gender Health Education Institute\u003c/a>, one of the first Chinese nongovernmental groups to focus on issues related to gender, sexuality and sexual health.\u003c/p>\n\u003cp>In China, homosexuality is still a taboo — listed as a mental illness until 2001, forbidden from film scenes. Because of its association with homosexuality, HIV/AIDS is effectively a taboo subject as well. Official data show around 654,000 people in the country live with HIV or AIDS, though researchers believe the actual number is likely higher.\u003c/p>\n\u003cp>Patients with HIV or AIDS say they are routinely turned away from hospitals and clinics when they seek care, despite regulations that explicitly forbid that kind of discrimination. Last July, phone scammers blackmailed hundreds of people with HIV or AIDS after obtaining their personal information through a data leak and threatening to reveal their identities if they didn't pay up.\u003c/p>\n\u003cp>That societal stigma has made promoting HIV/AIDS awareness and testing extremely difficult.\u003c/p>\n\u003cp>\"The most common psychological barriers given for not having HIV testing were perceived low risk of HIV infection and fears of being stigmatized for homosexuality,\" wrote the researchers for a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3076143/\">paper \u003c/a>on HIV/AIDS testing among \"MSM\" — men who have sex with men — who were migrants to Beijing from other parts of China.\u003c/p>\n\u003cp>So now Chinese health authorities are trying this vending machine tack to reach populations under 30, which experience higher rates of transmission than older age groups.\u003c/p>\n\u003cp>Such self-administered HIV tests are also available online. A search on Taobao, the Chinese e-commerce platform, turned up dozens of test brands costing around $15-$45 per kit. It was unclear how many had been approved by Chinese health authorities. Self-test kits operate in a gray area in China: The law states that the tests should be opened and used only in the presence of a medical professional.\u003c/p>\n\u003cp>The vending machine program is overseen by the \u003ca href=\"http://www.chinaaids.cn/english/aboutncaids/\">National Center for AIDS/STD Control and Prevention (NCAIDS)\u003c/a>, which, according to Chinese media reports, is subsidizing the cost to keep it at about $4. NCAIDS did not respond to a request for comment, citing a lengthy approval process before it could talk to foreign media.\u003c/p>\n\u003cp>Whether the vending machine tests will be used is still uncertain.\u003c/p>\n\u003cp>Local media reports say fewer than 10 kits have been sold at the Harbin Institute of Engineering, one of the campuses chosen for the pilot, since the vending machines came into use last November.\u003c/p>\n\u003cp>\"I think these kinds of method will yield some results but to what extent is still unclear. Right now, these vending machine test kits are not a significant channel for testing,\" says Liu Shi, program manager of the \u003ca href=\"http://www.chinaaidswalk.cn/\">China AIDS Walk\u003c/a> initiative.\u003c/p>\n\u003cp>Another challenge would be the time lapse between when a person contracts HIV and when they take a test, says Martin Yang of the Beijing Gender Health Education Institute. It can take up to several weeks for HIV to develop to a stage where it is detectable through a urine test.\u003c/p>\n\u003cp>But \u003ca href=\"http://www.jhsph.edu/faculty/directory/profile/53/chris-beyrer\">Dr. Chris Beyrer\u003c/a>, a professor at the Johns Hopkins Bloomberg School of Public Health, sees potential benefits. Beyrer, who is not involved in this vending machine program, notes in an email that \"there is always some window [of time]\" before a test will react to an infection. But he adds: \"The issue is that self-testing may reach people who are less likely to come into a clinic, so it may get to some people sooner in infection course and hopefully reduce onward transmission. So you have to look at this as ... the public health goal of getting people at risk to know their status, and for people at significant risk to regularize testing.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Emily Feng is a freelance journalist based in Beijing.\u003c/em>\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Why+China+Is+Selling+Cheap+HIV+Tests+In+Campus+Vending+Machines&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/379387/aids-stigma-prompts-china-to-sell-hiv-tests-in-campus-vending-machines","authors":["byline_futureofyou_379387"],"categories":["futureofyou_1"],"tags":["futureofyou_650","futureofyou_1263","futureofyou_1264","futureofyou_651"],"featImg":"futureofyou_387112","label":"futureofyou"},"futureofyou_297102":{"type":"posts","id":"futureofyou_297102","meta":{"index":"posts_1591205157","site":"futureofyou","id":"297102","score":null,"sort":[1481999228000]},"guestAuthors":[],"slug":"new-hiv-studies-offer-fresh-hope-for-a-cure","title":"New HIV Studies Offer Fresh Hope for a Cure","publishDate":1481999228,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>The HIV research community is increasingly optimistic about the promising \"shock and kill\" approach to eradicating HIV from infected patients. Such removal of all traces of the virus from an individual's body would represent an actual cure for AIDS.\u003c/p>\n\u003caside class=\"pullquote alignright\">'We know from the science that a cure can happen.'\u003c/aside>\n\u003cp>A new small-scale human trial of the treatment is starting this week in New York and two sister sites, in Germany and Denmark. The trial will combine an anticancer drug, romidepsin, with antiretroviral drugs, also known as ARVs.\u003c/p>\n\u003cp>Another small human study will start in January, followed by a larger human shock and kill trial in June.\u003c/p>\n\u003cp>Shock and kill combines standard ARVs with an immune booster, a combo that’s been effective in test tube, animal and now human trials. The treatment flushes out and eradicates pockets of HIV, which lie inactive inside dormant immune cells even as antiretroviral drugs reduce the actively reproducing virus to undetectable levels in the blood.\u003c/p>\n\u003cp>The new trials follow validating shock and kill data from University of California, San Francisco researchers, shared at the HIV Cure Summit, held on Dec. 1 at UCSF.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">[contextly_sidebar id=\"mMgRCnE0h9dNvCoKR8ZADxCU0RnaFUGQ\"]\"I feel a very real sense of optimism based on the evidence that we know a cure can be achieved,” said Dr. Rowena Johnston, vice-president for amfAR, in a post-summit interview with KQED. “There is a fundamental understanding we have now of the barriers between us and a cure, and how we go about to solving the problems.\"\u003c/span>\u003c/p>\n\u003cp class=\"p1\">In a related upcoming trial, a \u003cspan class=\"s1\">UCSF team will study whether an oral pill or IV drip is more effective in delivering drugs to tissue reservoirs where HIV hides. A separate observational study designed to serve as a reference for all HIV cure trials will monitor people who stop taking ARVs.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cstrong>Building on a Breakthrough\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">The mood at the HIV Cure Summit was one of cautious optimism, in part fueled by reports from the first human shock and kill trial in Britain. In October, UK scientists conducting a 50-person study announced that the first patient to complete the treatment, a 44-year-old man given Vorinostat, ARVs and vaccines to prod the immune system, \u003c/span>showed no detectable signs of the virus in his blood.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">In short, he appeared cured. But \u003c/span>\u003cspan class=\"s1\">HIV scientists worldwide quickly deemed any declaration of victory premature, cautioning that more time, as well as tissue samples, are needed to judge the treatment's efficacy. The UK trial will wrap up in 2018, and no results are expected until then.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003cb>Animal Studies Offer Hope – And a Warning \u003c/b>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">The early human findings mirror promising results from numerous lab and \u003cspan class=\"s2\">\u003ca href=\"http://www.iflscience.com/health-and-medicine/shock-and-kill-approach-cures-mice-hiv-world-first/\">animal studies\u003c/a> \u003c/span>employing shock and kill and related therapies. In October, researchers reported that several of eight monkeys given an immune therapy plus ARVs to flush out SIV, the simian cousin to HIV, now remain\u003ca href=\"http://www.reuters.com/article/us-aids-day-cure-analysis-idUSKBN13Q3BM\">\u003cspan class=\"s2\"> free\u003c/span>\u003c/a> of the virus after two years. The animals continue to be monitored. \u003c/span>\u003c/p>\n\u003cp class=\"p2\">\u003cspan class=\"s1\">But another group has just issued a cautionary note. It may be that not all approaches to boosting the immune system will prove safe, even if effective. On Dec. 12, scientists reported \u003ca href=\"http://www.pharmpro.com/news/2016/12/hiv-shock-and-kill-strategy-may-harm-patient-brains\" target=\"_blank\">brain inflammation\u003c/a> in a study of three SIV-infected macaques given a year’s course of Vorinostat; Ingenol-B, another latency-reversing agent; and ARVs. While Vorinostat has passed human safety studies, Ingenol-B has not, said Johnston.\u003c/span>\u003c/p>\n\u003cp class=\"p3\">\u003cspan class=\"s1\">\"Our study sounds a major cautionary note about the potential for unintended consequences of the shock-and-kill treatment strategy,\" stated Janice Clements, a veteran AIDS researchers at the Johns Hopkins University School of Medicine.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003cb>The Berlin Patient\u003c/b>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">At the UCSF summit, researchers stressed the difference between a full or sterilizing cure, which would constitute eradication of every last particle of HIV, and a functional cure, meaning remission. In the latter, the immune system prevents HIV from ever emerging out of dormancy.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">A total cure has only been achieved in one person to date: Timothy Ray Brown, also known as \u003ca href=\"http://www.sciencemag.org/news/2014/09/how-did-berlin-patient-rid-himself-hiv\" target=\"_blank\">The Berlin Patient\u003c/a>. Brown was initially infected with HIV in 1995. After years of antiretroviral drugs, Brown, who also suffers from acute myeloid leukemia, underwent chemotherapy followed by two stem cell transplants from a donor whose immune cells were genetically resistant to HIV. Today, nine years later, Brown remains free of any trace of the virus in not only his bloodstream but in myriad tissue samples. He recently relocated to participate in studies in San Francisco. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“The Berlin Patient gave us the proof of concept” for an HIV cure, said Kevin Frost, amfAR CEO and the summit spokesperson. Referring to the number of people with HIV globally, he said, “Now we have to go from N-1 to N-37 million.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">The Berlin Patient's case was unique and his treatment prohibitively expensive, out of reach to millions with HIV. In the short term, a more realistic remedy than eradication of the virus is remission without antiretroviral drugs. A small minority of long-term HIV survivors, called \"\u003ca href=\"http://www.sfchronicle.com/health/article/Protected-from-HIV-elite-controllers-still-10420068.php\">\u003cspan class=\"s2\">elite controllers\u003c/span>\u003c/a>,\" already can manage without the drugs due to their own immune systems.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">If shock and kill therapies prove effective and durable, they will also prove a boon for HIV prevention. Two major \u003ca href=\"https://hptn.org/research/studies/33\">\u003cspan class=\"s2\">studies\u003c/span>\u003c/a> over the last five years in thousands of couples showed that individuals on ARVs with undetectable levels of HIV were \u003cspan class=\"s2\">\u003ca href=\"http://i-base.info/htb/30108\">not infectious. \u003c/a>\u003c/span>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">A number of preventive shock and kill vaccines are now being evaluated in new laboratory studies.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003cb>Needed: R&D for New Tools\u003c/b>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Some of the buzz at the HIV Cure Summit focused on progress made with new tools to find, measure, and map latent HIV. UCSF's Peter Hunt introduced results of a new RNA-DNA probe that can simultaneously measure dormant and replicating HIV in tissue cells, as well as pinpoint the cell type. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">That allows for mapping of not only the regions where reservoirs of HIV are lurking but the individual cells, explained Johnston. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“It’s an incredible advance,\" Johnston said. \"There’s not a single group in the world who has done that.” \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Another UCSF researcher, Satish Pillai, presented a novel digital-drop technology and multifluid chip test that can analyze many cells at once. Such tools are critical to assess if patients off medicines will remain HIV-free.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Looking ahead, Frost of amfAR thought a barrier to more rapid progress is a lack of pharma investment in research and diagnostics. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“In the development of antiretrovirals, the pace of research accelerated at a speed commensurate with the revenue generated,\" he said. \"With only a few exceptions, pharma hasn’t even come to the table on cure research yet.” \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">HIV cure proponents also worry about possible cuts in research dollars under incoming President Donald Trump.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">But such hurdles haven’t dampened their growing faith in a cure. \u003c/span>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“We know from the science that a cure can happen,” said Pillai. “That’s definitely a reason to be hopeful. We just need more resources and more people involved to move us along faster.”\u003c/span>\u003c/p>\n\n","blocks":[],"excerpt":"Scientists are increasingly optimistic about the promising 'shock and kill' approach to eradicating HIV from infected patients. ","status":"publish","parent":0,"modified":1482125312,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":7,"wordCount":1232},"headData":{"title":"New HIV Studies Offer Fresh Hope for a Cure | KQED","description":"Scientists are increasingly optimistic about the promising 'shock and kill' approach to eradicating HIV from infected patients. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"297102 http://ww2.kqed.org/futureofyou/?p=297102","disqusUrl":"https://ww2.kqed.org/futureofyou/2016/12/17/new-hiv-studies-offer-fresh-hope-for-a-cure/","disqusTitle":"New HIV Studies Offer Fresh Hope for a Cure","source":"KQED Future of You","customPermalink":"2016/12/13/hiv-cure/","nprByline":"Anne-christine d'Adesky","path":"/futureofyou/297102/new-hiv-studies-offer-fresh-hope-for-a-cure","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The HIV research community is increasingly optimistic about the promising \"shock and kill\" approach to eradicating HIV from infected patients. Such removal of all traces of the virus from an individual's body would represent an actual cure for AIDS.\u003c/p>\n\u003caside class=\"pullquote alignright\">'We know from the science that a cure can happen.'\u003c/aside>\n\u003cp>A new small-scale human trial of the treatment is starting this week in New York and two sister sites, in Germany and Denmark. The trial will combine an anticancer drug, romidepsin, with antiretroviral drugs, also known as ARVs.\u003c/p>\n\u003cp>Another small human study will start in January, followed by a larger human shock and kill trial in June.\u003c/p>\n\u003cp>Shock and kill combines standard ARVs with an immune booster, a combo that’s been effective in test tube, animal and now human trials. The treatment flushes out and eradicates pockets of HIV, which lie inactive inside dormant immune cells even as antiretroviral drugs reduce the actively reproducing virus to undetectable levels in the blood.\u003c/p>\n\u003cp>The new trials follow validating shock and kill data from University of California, San Francisco researchers, shared at the HIV Cure Summit, held on Dec. 1 at UCSF.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003c/p>\u003cp>\u003c/p>\u003cp>\"I feel a very real sense of optimism based on the evidence that we know a cure can be achieved,” said Dr. Rowena Johnston, vice-president for amfAR, in a post-summit interview with KQED. “There is a fundamental understanding we have now of the barriers between us and a cure, and how we go about to solving the problems.\"\u003c/span>\u003c/p>\n\u003cp class=\"p1\">In a related upcoming trial, a \u003cspan class=\"s1\">UCSF team will study whether an oral pill or IV drip is more effective in delivering drugs to tissue reservoirs where HIV hides. A separate observational study designed to serve as a reference for all HIV cure trials will monitor people who stop taking ARVs.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cstrong>Building on a Breakthrough\u003c/strong>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">The mood at the HIV Cure Summit was one of cautious optimism, in part fueled by reports from the first human shock and kill trial in Britain. In October, UK scientists conducting a 50-person study announced that the first patient to complete the treatment, a 44-year-old man given Vorinostat, ARVs and vaccines to prod the immune system, \u003c/span>showed no detectable signs of the virus in his blood.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">In short, he appeared cured. But \u003c/span>\u003cspan class=\"s1\">HIV scientists worldwide quickly deemed any declaration of victory premature, cautioning that more time, as well as tissue samples, are needed to judge the treatment's efficacy. The UK trial will wrap up in 2018, and no results are expected until then.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003cb>Animal Studies Offer Hope – And a Warning \u003c/b>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">The early human findings mirror promising results from numerous lab and \u003cspan class=\"s2\">\u003ca href=\"http://www.iflscience.com/health-and-medicine/shock-and-kill-approach-cures-mice-hiv-world-first/\">animal studies\u003c/a> \u003c/span>employing shock and kill and related therapies. In October, researchers reported that several of eight monkeys given an immune therapy plus ARVs to flush out SIV, the simian cousin to HIV, now remain\u003ca href=\"http://www.reuters.com/article/us-aids-day-cure-analysis-idUSKBN13Q3BM\">\u003cspan class=\"s2\"> free\u003c/span>\u003c/a> of the virus after two years. The animals continue to be monitored. \u003c/span>\u003c/p>\n\u003cp class=\"p2\">\u003cspan class=\"s1\">But another group has just issued a cautionary note. It may be that not all approaches to boosting the immune system will prove safe, even if effective. On Dec. 12, scientists reported \u003ca href=\"http://www.pharmpro.com/news/2016/12/hiv-shock-and-kill-strategy-may-harm-patient-brains\" target=\"_blank\">brain inflammation\u003c/a> in a study of three SIV-infected macaques given a year’s course of Vorinostat; Ingenol-B, another latency-reversing agent; and ARVs. While Vorinostat has passed human safety studies, Ingenol-B has not, said Johnston.\u003c/span>\u003c/p>\n\u003cp class=\"p3\">\u003cspan class=\"s1\">\"Our study sounds a major cautionary note about the potential for unintended consequences of the shock-and-kill treatment strategy,\" stated Janice Clements, a veteran AIDS researchers at the Johns Hopkins University School of Medicine.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003cb>The Berlin Patient\u003c/b>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">At the UCSF summit, researchers stressed the difference between a full or sterilizing cure, which would constitute eradication of every last particle of HIV, and a functional cure, meaning remission. In the latter, the immune system prevents HIV from ever emerging out of dormancy.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">A total cure has only been achieved in one person to date: Timothy Ray Brown, also known as \u003ca href=\"http://www.sciencemag.org/news/2014/09/how-did-berlin-patient-rid-himself-hiv\" target=\"_blank\">The Berlin Patient\u003c/a>. Brown was initially infected with HIV in 1995. After years of antiretroviral drugs, Brown, who also suffers from acute myeloid leukemia, underwent chemotherapy followed by two stem cell transplants from a donor whose immune cells were genetically resistant to HIV. Today, nine years later, Brown remains free of any trace of the virus in not only his bloodstream but in myriad tissue samples. He recently relocated to participate in studies in San Francisco. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“The Berlin Patient gave us the proof of concept” for an HIV cure, said Kevin Frost, amfAR CEO and the summit spokesperson. Referring to the number of people with HIV globally, he said, “Now we have to go from N-1 to N-37 million.”\u003c/span>\u003c/p>\n\u003cp class=\"p1\">The Berlin Patient's case was unique and his treatment prohibitively expensive, out of reach to millions with HIV. In the short term, a more realistic remedy than eradication of the virus is remission without antiretroviral drugs. A small minority of long-term HIV survivors, called \"\u003ca href=\"http://www.sfchronicle.com/health/article/Protected-from-HIV-elite-controllers-still-10420068.php\">\u003cspan class=\"s2\">elite controllers\u003c/span>\u003c/a>,\" already can manage without the drugs due to their own immune systems.\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">If shock and kill therapies prove effective and durable, they will also prove a boon for HIV prevention. Two major \u003ca href=\"https://hptn.org/research/studies/33\">\u003cspan class=\"s2\">studies\u003c/span>\u003c/a> over the last five years in thousands of couples showed that individuals on ARVs with undetectable levels of HIV were \u003cspan class=\"s2\">\u003ca href=\"http://i-base.info/htb/30108\">not infectious. \u003c/a>\u003c/span>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">A number of preventive shock and kill vaccines are now being evaluated in new laboratory studies.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">\u003cb>Needed: R&D for New Tools\u003c/b>\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Some of the buzz at the HIV Cure Summit focused on progress made with new tools to find, measure, and map latent HIV. UCSF's Peter Hunt introduced results of a new RNA-DNA probe that can simultaneously measure dormant and replicating HIV in tissue cells, as well as pinpoint the cell type. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">That allows for mapping of not only the regions where reservoirs of HIV are lurking but the individual cells, explained Johnston. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“It’s an incredible advance,\" Johnston said. \"There’s not a single group in the world who has done that.” \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Another UCSF researcher, Satish Pillai, presented a novel digital-drop technology and multifluid chip test that can analyze many cells at once. Such tools are critical to assess if patients off medicines will remain HIV-free.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">Looking ahead, Frost of amfAR thought a barrier to more rapid progress is a lack of pharma investment in research and diagnostics. \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“In the development of antiretrovirals, the pace of research accelerated at a speed commensurate with the revenue generated,\" he said. \"With only a few exceptions, pharma hasn’t even come to the table on cure research yet.” \u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">HIV cure proponents also worry about possible cuts in research dollars under incoming President Donald Trump.\u003c/span>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">But such hurdles haven’t dampened their growing faith in a cure. \u003c/span>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp class=\"p1\">\u003cspan class=\"s1\">“We know from the science that a cure can happen,” said Pillai. “That’s definitely a reason to be hopeful. We just need more resources and more people involved to move us along faster.”\u003c/span>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/297102/new-hiv-studies-offer-fresh-hope-for-a-cure","authors":["byline_futureofyou_297102"],"categories":["futureofyou_452","futureofyou_1062","futureofyou_1","futureofyou_73"],"tags":["futureofyou_650","futureofyou_651","futureofyou_80","futureofyou_1145"],"featImg":"futureofyou_300105","label":"source_futureofyou_297102"},"futureofyou_152825":{"type":"posts","id":"futureofyou_152825","meta":{"index":"posts_1591205157","site":"futureofyou","id":"152825","score":null,"sort":[1461687982000]},"guestAuthors":[],"slug":"people-who-are-hiv-positive-may-be-aging-faster","title":"People Who Are HIV-Positive May Age Faster","publishDate":1461687982,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>Having HIV — or getting treatment for it — speeds up the aging process by about five years, on average, scientists report in a new study.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.cell.com/molecular-cell/abstract/S1097-2765(16)30002-8\">findings\u003c/a>, published in the journal \u003cem>Molecular Cell\u003c/em>, fit with what doctors have seen in clinics: HIV-positive people tend to get hit earlier in life with age-related diseases, such as osteoporosis, heart disease and dementia.\u003c/p>\n\u003cp>But the study also opens up the possibility of addressing a broader question: How to measure a disease's impact on aging.\u003c/p>\n\u003cp>\"We all know that some people appear to age faster than others,\" says \u003ca href=\"http://healthsciences.ucsd.edu/som/medicine/research/labs/ideker/Pages/default.aspx\">Trey Ideker\u003c/a>, a biologist at the University of California, San Diego, who co-led the study. \"There are external signs of aging, like gray hair and wrinkles. But the inside of our bodies also show signs.\"\u003c/p>\n\u003cp>One of those signals is hidden in our genomes — not the genetic code itself but how the genome is decorated.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Before you're born, your DNA gets decorated with little tags, called \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3174260/\">methylation\u003c/a>, which help turn genes on and off. As you age, some tags fall off. Others get added. By looking at the pattern of these tags, Ideker and his colleagues \u003ca href=\"http://www.cell.com/molecular-cell/abstract/S1097-2765(12)00893-3?_returnURL=http%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS1097276512008933%3Fshowall%3Dtrue\">found\u003c/a> they could estimate how fast a person is aging.\u003c/p>\n\u003cp>\"And that measurement is better at predicting when someone will die than their chronological age — or the number of years they've been on Earth,\" Ideker says.\u003c/p>\n\u003cp>For instance, say you're 50 years old, but your DNA tags look like you're 55. Then your body is aging about 10 percent faster than the average 50-year-old's body. And you might want to get screened for age-related diseases five years earlier.\u003c/p>\n\u003cp>That's exactly what Ideker and his team found for men with HIV.\u003c/p>\n\u003cp>The team analyzed more than 25,000 DNA tags on the genomes of 137 HIV-positive men. The researchers then used the patterns in the tags to estimate each man's \"biological age\" compared to his chronological age.\u003c/p>\n\u003cp>On average, each man's DNA looked like he was about five years older than his actual age. And it didn't matter if he had had HIV for more than a decade or if he was only recently infected. The bump in biological age was about the same.\u003c/p>\n\u003cp>All the men in the study were taking antiretroviral drugs. So Ideker and his team couldn't tell whether the age advancement is linked to the HIV infection itself or the drugs used to treat it.\u003c/p>\n\u003cp>Still, though, \u003ca href=\"http://www.unmc.edu/pharmacology/faculty/primary-faculty/fox/\">Dr. Howard Fox\u003c/a> at the University of Nebraska Medical Center hopes the findings will help promote a healthy lifestyle among people who are aging with HIV.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"People think, 'I'm taking my retroviral drugs so there's no need to worry about my health,' \" says Fox, who co-led the current study with Ideker. \"But HIV puts you at an increased risk for other diseases. Whatever you can do to slow down the aging process — exercise, eating right — will help to offset this.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=People+Who+Are+HIV-Positive+May+Be+Aging+Faster+Than+Their+Peers&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"A study finds that HIV infection — or the treatment for it — can have an impact on the way the body ages.","status":"publish","parent":0,"modified":1476852113,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":16,"wordCount":519},"headData":{"title":"People Who Are HIV-Positive May Age Faster | KQED","description":"A study finds that HIV infection — or the treatment for it — can have an impact on the way the body ages.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"152825 http://ww2.kqed.org/futureofyou/?p=152825","disqusUrl":"https://ww2.kqed.org/futureofyou/2016/04/26/people-who-are-hiv-positive-may-be-aging-faster/","disqusTitle":"People Who Are HIV-Positive May Age Faster","nprByline":"Michaeleen Doucleff\u003cbr />NPR Goats and Soda","nprImageAgency":"Joseph Daniel Fiedler for NPR","nprStoryId":"474843768","nprApiLink":"http://api.npr.org/query?id=474843768&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/goatsandsoda/2016/04/26/474843768/people-who-are-hiv-positive-may-be-aging-faster-than-their-peers?ft=nprml&f=474843768","nprRetrievedStory":"1","nprPubDate":"Tue, 26 Apr 2016 11:58:00 -0400","nprStoryDate":"Tue, 26 Apr 2016 09:16:00 -0400","nprLastModifiedDate":"Tue, 26 Apr 2016 11:58:46 -0400","path":"/futureofyou/152825/people-who-are-hiv-positive-may-be-aging-faster","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Having HIV — or getting treatment for it — speeds up the aging process by about five years, on average, scientists report in a new study.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.cell.com/molecular-cell/abstract/S1097-2765(16)30002-8\">findings\u003c/a>, published in the journal \u003cem>Molecular Cell\u003c/em>, fit with what doctors have seen in clinics: HIV-positive people tend to get hit earlier in life with age-related diseases, such as osteoporosis, heart disease and dementia.\u003c/p>\n\u003cp>But the study also opens up the possibility of addressing a broader question: How to measure a disease's impact on aging.\u003c/p>\n\u003cp>\"We all know that some people appear to age faster than others,\" says \u003ca href=\"http://healthsciences.ucsd.edu/som/medicine/research/labs/ideker/Pages/default.aspx\">Trey Ideker\u003c/a>, a biologist at the University of California, San Diego, who co-led the study. \"There are external signs of aging, like gray hair and wrinkles. But the inside of our bodies also show signs.\"\u003c/p>\n\u003cp>One of those signals is hidden in our genomes — not the genetic code itself but how the genome is decorated.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Before you're born, your DNA gets decorated with little tags, called \u003ca href=\"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3174260/\">methylation\u003c/a>, which help turn genes on and off. As you age, some tags fall off. Others get added. By looking at the pattern of these tags, Ideker and his colleagues \u003ca href=\"http://www.cell.com/molecular-cell/abstract/S1097-2765(12)00893-3?_returnURL=http%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS1097276512008933%3Fshowall%3Dtrue\">found\u003c/a> they could estimate how fast a person is aging.\u003c/p>\n\u003cp>\"And that measurement is better at predicting when someone will die than their chronological age — or the number of years they've been on Earth,\" Ideker says.\u003c/p>\n\u003cp>For instance, say you're 50 years old, but your DNA tags look like you're 55. Then your body is aging about 10 percent faster than the average 50-year-old's body. And you might want to get screened for age-related diseases five years earlier.\u003c/p>\n\u003cp>That's exactly what Ideker and his team found for men with HIV.\u003c/p>\n\u003cp>The team analyzed more than 25,000 DNA tags on the genomes of 137 HIV-positive men. The researchers then used the patterns in the tags to estimate each man's \"biological age\" compared to his chronological age.\u003c/p>\n\u003cp>On average, each man's DNA looked like he was about five years older than his actual age. And it didn't matter if he had had HIV for more than a decade or if he was only recently infected. The bump in biological age was about the same.\u003c/p>\n\u003cp>All the men in the study were taking antiretroviral drugs. So Ideker and his team couldn't tell whether the age advancement is linked to the HIV infection itself or the drugs used to treat it.\u003c/p>\n\u003cp>Still, though, \u003ca href=\"http://www.unmc.edu/pharmacology/faculty/primary-faculty/fox/\">Dr. Howard Fox\u003c/a> at the University of Nebraska Medical Center hopes the findings will help promote a healthy lifestyle among people who are aging with HIV.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"People think, 'I'm taking my retroviral drugs so there's no need to worry about my health,' \" says Fox, who co-led the current study with Ideker. \"But HIV puts you at an increased risk for other diseases. Whatever you can do to slow down the aging process — exercise, eating right — will help to offset this.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=People+Who+Are+HIV-Positive+May+Be+Aging+Faster+Than+Their+Peers&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/152825/people-who-are-hiv-positive-may-be-aging-faster","authors":["byline_futureofyou_152825"],"categories":["futureofyou_1062"],"tags":["futureofyou_650","futureofyou_17","futureofyou_120","futureofyou_651"],"featImg":"futureofyou_152826","label":"futureofyou"},"futureofyou_134669":{"type":"posts","id":"futureofyou_134669","meta":{"index":"posts_1591205157","site":"futureofyou","id":"134669","score":null,"sort":[1459207219000]},"guestAuthors":[],"slug":"truvada-the-miracle-hiv-drug-few-people-take-suffers-another-setback","title":"Truvada, the Miracle HIV Drug Few People Take, Suffers Another Setback","publishDate":1459207219,"format":"standard","headTitle":"Future of You | KQED Future of You | KQED Science","labelTerm":{"term":54,"site":"futureofyou"},"content":"\u003cp>The first documented case of HIV infection by someone adhering to the prescribed regimen for the preventive HIV drug Truvada was reported at a medical conference last month.\u003c/p>\n\u003cp>Dr. David Knox, an HIV primary care physician at Toronto's Maple Leaf Medical Clinic, reported the case at the \u003ca href=\"http://www.croiconference.org/sessions/hiv-1-infection-multiclass-resistance-despite-preexposure-prophylaxis-prep\" target=\"_blank\" rel=\"nofollow\">Conference on Retroviruses and Opportunistic Infections in Boston\u003c/a>. (You can listen to his full presentation \u003ca href=\"http://streamst3.capitalreach.com/c/croi/2016croi/29737.mp3?isMobileView=false&detectedMobile=false\" target=\"_blank\">here\u003c/a>.)\u003c/p>\n\u003cp>Truvada, called PrEP for \"pre-exposure prophylaxis\" when used as a prophylactic, is an FDA-approved combination of two drugs that is also used to treat HIV. Since 2012, it's also been prescribed to HIV-negative individuals in high-risk populations who want to prevent infection.\u003c/p>\n\u003cp>The patient who represents the first PrEP failure was a 43-year-old man who had taken Truvada for approximately two years, Knox said in an email. Before his infection, the man had multiple encounters in which he engaged in high-risk sexual behavior.\u003c/p>\n\u003cp>Knox said his patient had \"a very resistant strain of virus\" and that the failure of PrEP was probably rare.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Just last September, an analysis by researchers at Kaiser San Francisco \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/09/02/no-new-infections-in-hundreds-taking-pill-to-prevent-hiv/\" target=\"_blank\">found no new HIV infections \u003c/a>in over a two-and-a-half-year period among patients who took PrEP.\u003c/p>\n\u003cp>Ryan McKeel, a spokesman for Gilead Sciences, Truvada's manufacturer, said in an email that \"no single intervention is 100 percent effective in preventing HIV. In this case, the individual contracted HIV while taking PrEP due to exposure to a rare strain of HIV that is resistant to both of the drugs included in Truvada.\"\u003c/p>\n\u003cp>\u003cb>Truvada: The Miracle Drug No One's Taking\u003c/b>\u003c/p>\n\u003cp>Before the FDA approval of PrEP, in 2011, I \u003ca href=\"http://ww2.kqed.org/news/2011/07/15/interview-new-studies-show-anti-hiv-drug-prevents-transmission\" target=\"_blank\">interviewed the seminal AIDS researcher Dr. Paul Volberding\u003c/a> about studies showing Truvada's effectiveness in preventing HIV transmission. He was tremendously excited about the possibilities of a prophylactic drug. \"This is the kind of effect we might expect from a very good vaccine,\" he said.\u003c/p>\n\u003cp>That enthusiasm has spread to both the Centers for Disease Control and the World Health Organization. CDC now says\u003ca href=\"https://www.washingtonpost.com/news/to-your-health/wp/2015/11/24/cdc-on-hiv-prevention-pill-how-to-tell-whether-you-should-be-taking-the-medication/\" target=\"_blank\"> about 1.2 million people \u003c/a>should at least consider PrEP, and four months ago the World Health Organization broadened its recommendation of who should take the medication, from men who have sex with men to \"all population groups at substantial risk of HIV infection.\"\u003c/p>\n\u003cp>Yet, what some have called a \"\u003ca href=\"https://www.washingtonpost.com/opinions/the-miracle-aids-drug-that-people-refust-to-take/2016/01/29/ba2b9460-b88a-11e5-b682-4bb4dd403c7d_story.html\" target=\"_blank\">miracle drug\u003c/a>\" that \u003ca href=\"http://www.nytimes.com/2014/07/17/upshot/is-truvada-the-pill-to-prevent-hiv-99-percent-effective-dont-be-so-sure.html?_r=0\" target=\"_blank\">works better\u003c/a> than \u003ca href=\"http://www.aidsmap.com/Consistent-condom-use-in-anal-sex-stops-70-of-HIV-infections-study-finds-but-intermittent-use-has-no-effect/page/2586976/\" target=\"_blank\">condoms\u003c/a> has been a bust in terms of adoption by the public.\u003c/p>\n\u003cp>\"\u003ca href=\"http://www.newyorker.com/tech/elements/why-is-no-one-on-the-first-treatment-to-prevent-h-i-v\" target=\"_blank\">Why Is No One On the First Treatment To Prevent H.I.V.?\u003c/a>\" The New Yorker asked in 2013.\u003c/p>\n\u003cp>\"Why have \u003ca href=\"http://www.natap.org/2013/ICAAC/ICAAC_04.htm\" target=\"_blank\">only 1,774 people\u003c/a>—half of whom are women—filled Truvada prescriptions over the last two years?\" \u003ca href=\"http://www.slate.com/blogs/outward/2014/01/06/truvada_prep_hiv_gay_men_should_take_pre_exposure_prophylaxis.html\" target=\"_blank\">Slate\u003c/a> asked in 2014.\u003c/p>\n\u003cp>\"Gilead’s Pill Can Stop HIV. So Why Does Almost Nobody Take It?\" \u003ca href=\"http://www.bloomberg.com/news/articles/2015-02-18/gilead-s-pill-can-stop-hiv-so-why-does-almost-nobody-take-it-\" target=\"_blank\">Bloomberg asked\u003c/a> in 2015.\u003c/p>\n\u003cp>\"\u003ca href=\"https://www.washingtonpost.com/opinions/the-miracle-aids-drug-that-people-refust-to-take/2016/01/29/ba2b9460-b88a-11e5-b682-4bb4dd403c7d_story.html\" target=\"_blank\">The miracle AIDS drug that people refuse to take,\u003c/a>\" an op-ed headline in The Washington Post read just two months ago.\u003c/p>\n\u003cp>\"Truvada’s been a financial success, bringing Gilead $1.79 billion in the U.S last year,\" Bloomberg reported in July. But that is due to its use by HIV-positive patients, not in those taking it for prevention. The report cited a \u003ca href=\"http://www.jiasociety.org/index.php/jias/article/view/19730/html\" target=\"_blank\">study\u003c/a> published in the November 2014 Journal of the International AIDS Society that found an unbelievably low 3,253 people, in the U.S., had used Truvada for PrEP between January 2012 and March 2014 -- only about 1,900 of those men.\u003c/p>\n\u003cp>The CDC says that figure is now about 21,000. According to an October 2015 \u003ca href=\"http://www.iapac.org/tasp_prep/presentations/TPSparis15-Panel-Grant.pdf\" target=\"_blank\">presentation\u003c/a> by Dr. Robert Grant, the protocol chair for a \u003ca href=\"https://www.google.com/search?q=iprex+study\" target=\"_blank\">multinational study on PrEP\u003c/a>, the number of U.S. users is about 22,000, and use of the drug \"has reached a tipping point.\"\u003c/p>\n\u003cp>Not according to Michael Weinstein, president of AIDS Healthcare Foundation, a global HIV/AIDS organization. Weinstein has been \u003ca href=\"https://www.frontiersmedia.com/frontiers-blog/2016/01/07/aids-healthcare-foundation-continues-to-wage-war-against-prep-reignites-party-drug-rhetoric/\" target=\"_blank\">outspoken\u003c/a> against mass adoption of Truvada, arguing it's a poor public health solution and drawing the wrath of some in the HIV health community. (The New York Times' Upshot \u003ca href=\"http://www.nytimes.com/2014/11/17/upshot/aids-group-wages-lonely-fight-against-pill-to-prevent-hiv.html\" target=\"_blank\">column\u003c/a> called him \"the most hated man in the AIDS business\" in 2014.)\u003c/p>\n\u003cp>Weinstein is well aware that the number of people taking Truvada is trivial.\u003c/p>\n\u003cp>\"The bottom line is we are now almost four years since the approval of this, and the last report from the CDC was that 21,000 people were taking it. Really, it's an insignificant number.\"\u003c/p>\n\u003cp>He said he thought the recent report about the Truvada failure out of Toronto \"will give some people pause\" about the drug. And he thinks the focus on Truvada is wrongheaded:\u003c/p>\n\u003cp>\"The messaging coming out is all about Truvada and PrEP, and not about condoms,\" he said. \"So we're seeing this huge s\u003ca href=\"http://www.cdc.gov/nchhstp/newsroom/2015/std-surveillance-report-press-release.html\" target=\"_blank\">pike in STDs\u003c/a> across the country. And I think it's because the CDC has really taken their foot off the gas and they're not saying anything about safer sex.\"\u003c/p>\n\u003cp>Dana Van Gorder is the executive director of Project Inform, which advocates for new HIV and hepatitis C treatments. He agrees that reduced condom use is a big factor in the rise of STDs. But he says PrEP use is so minimal, it can't be the culprit. Plus PrEP is better.\u003c/p>\n\u003cp>\"Condoms have been a great device, but on a statistical level, they're not as effective as PrEP can be in preventing infections, and the reality is just that not everyone is going to use them, for a variety of different reasons. So it feels unethical to us to not provide people with another option.\u003c/p>\n\u003cp>\"We can't just wish that people are going to use condoms more than they are.\"\u003c/p>\n\u003cp>Van Gorder said those who support Truvada were \"disappointed\" over the news it had failed for someone. But, he said, \"We'll continue to encourage PrEP use and stress it is highly effective but not necessarily 100 percent effective.\"\u003c/p>\n\u003cp>\u003cstrong>What, Exactly, is the Problem?\u003c/strong>\u003c/p>\n\u003cp>The reasons for PrEP's failure to catch on are manifold, Van Gorder said: Lack of effective education campaigns among \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/08/01/why-latinos-arent-taking-the-anti-hiv-pill-and-why-they-should-consider-it/\" target=\"_blank\">people of color\u003c/a> and injection drug users, for one; the need for follow-up appontments and testing, for another.\u003c/p>\n\u003cp>Also, he said, health care providers are not talking enough about PrEP to their patients. Some \"are actually hostile to it,\" he said.\u003c/p>\n\u003cp>Finally, Van Gorder said, PrEP is expensive. \"Covering its cost is not a small matter. While many insurers if not most are covering it, people often have high cost of sharing with deductibles and copays. Not everyone is in a position to [use] it.\"\u003c/p>\n\u003cp>But as Lisa Aliferis reported in KQED's \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/09/02/no-new-infections-in-hundreds-taking-pill-to-prevent-hiv/\" target=\"_blank\">State of Health blog\u003c/a> last September, there's another reason PrEP has failed to take off:\u003c/p>\n\u003cp>\"Despite the success of PrEP as a preventive, stigma remains,\" Aliferis wrote. \"People who take PrEP are sometimes viewed as promiscuous, [A PrEP patient] told me. “People say, ‘Why are you not just using condoms?’ … Sometimes people say, ‘You must be a slut.’\u003c/p>\n\u003cp>In fact, the term \"\u003ca href=\"http://www.advocate.com/health/2014/08/11/truvada-whore-stigma-endures-among-doctors-and-lgbts\" target=\"_blank\">Truvada whore\u003c/a>\" has often been used to describe PrEP users ... and not in a nice way, either. (The term has been\u003ca href=\"http://www.out.com/entertainment/popnography/2014/05/20/why-i-am-truvada-whore\" target=\"_blank\"> co-opted\u003c/a> by some Truvada fans.)\u003c/p>\n\u003cp>\u003cstrong>The Patient Speaks\u003c/strong>\u003c/p>\n\u003cp>Earlier this month, POZ, a magazine for people who are HIV-positive, published an \u003ca href=\"https://www.poz.com/article/meet-man-got-hiv-daily-prep\" target=\"_blank\">anonymous-yet-candid interview\u003c/a> with the Canadian PrEP user who still became infected.\u003c/p>\n\u003cp>When asked if PrEP altered his sexual behavior or attitudes, he answered:\u003c/p>\n\u003cp>\"Yes. I became more sexually liberated. It took away the fear. I mean, that’s really one of the reasons why people behave themselves [sexually]. It’s not because of morals or religion or society; it’s just the fear of getting sick—especially the fear of HIV. But once you’re on PrEP you’re more comfortable. You feel safer.\"\u003c/p>\n\u003cp>\u003cspan style=\"line-height: 1.5\">He said he's still a fan of the drug, despite its failure.\u003c/span>\u003c/p>\n\u003cp>\"PrEP’s a calculated risk,\" he said. \"It’s important for people to know that there is the possibility as opposed to the fantasy that there have been no recorded infections on PrEP. At least now there is one, so it makes it more real.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp> \u003c/p>\n\n","blocks":[],"excerpt":"Truvada, or PrEP, prevents HIV infection in healthy people. It's been foolproof, until now. ","status":"publish","parent":0,"modified":1459277166,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":41,"wordCount":1442},"headData":{"title":"Truvada, the Miracle HIV Drug Few People Take, Suffers Another Setback | KQED","description":"Truvada, or PrEP, prevents HIV infection in healthy people. It's been foolproof, until now. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"134669 http://ww2.kqed.org/futureofyou/?p=134669","disqusUrl":"https://ww2.kqed.org/futureofyou/2016/03/28/truvada-the-miracle-hiv-drug-few-people-take-suffers-another-setback/","disqusTitle":"Truvada, the Miracle HIV Drug Few People Take, Suffers Another Setback","path":"/futureofyou/134669/truvada-the-miracle-hiv-drug-few-people-take-suffers-another-setback","audioUrl":"http://streamst3.capitalreach.com/c/croi/2016croi/29737.mp3?isMobileView=false&","audioDuration":null,"audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The first documented case of HIV infection by someone adhering to the prescribed regimen for the preventive HIV drug Truvada was reported at a medical conference last month.\u003c/p>\n\u003cp>Dr. David Knox, an HIV primary care physician at Toronto's Maple Leaf Medical Clinic, reported the case at the \u003ca href=\"http://www.croiconference.org/sessions/hiv-1-infection-multiclass-resistance-despite-preexposure-prophylaxis-prep\" target=\"_blank\" rel=\"nofollow\">Conference on Retroviruses and Opportunistic Infections in Boston\u003c/a>. (You can listen to his full presentation \u003ca href=\"http://streamst3.capitalreach.com/c/croi/2016croi/29737.mp3?isMobileView=false&detectedMobile=false\" target=\"_blank\">here\u003c/a>.)\u003c/p>\n\u003cp>Truvada, called PrEP for \"pre-exposure prophylaxis\" when used as a prophylactic, is an FDA-approved combination of two drugs that is also used to treat HIV. Since 2012, it's also been prescribed to HIV-negative individuals in high-risk populations who want to prevent infection.\u003c/p>\n\u003cp>The patient who represents the first PrEP failure was a 43-year-old man who had taken Truvada for approximately two years, Knox said in an email. Before his infection, the man had multiple encounters in which he engaged in high-risk sexual behavior.\u003c/p>\n\u003cp>Knox said his patient had \"a very resistant strain of virus\" and that the failure of PrEP was probably rare.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Just last September, an analysis by researchers at Kaiser San Francisco \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/09/02/no-new-infections-in-hundreds-taking-pill-to-prevent-hiv/\" target=\"_blank\">found no new HIV infections \u003c/a>in over a two-and-a-half-year period among patients who took PrEP.\u003c/p>\n\u003cp>Ryan McKeel, a spokesman for Gilead Sciences, Truvada's manufacturer, said in an email that \"no single intervention is 100 percent effective in preventing HIV. In this case, the individual contracted HIV while taking PrEP due to exposure to a rare strain of HIV that is resistant to both of the drugs included in Truvada.\"\u003c/p>\n\u003cp>\u003cb>Truvada: The Miracle Drug No One's Taking\u003c/b>\u003c/p>\n\u003cp>Before the FDA approval of PrEP, in 2011, I \u003ca href=\"http://ww2.kqed.org/news/2011/07/15/interview-new-studies-show-anti-hiv-drug-prevents-transmission\" target=\"_blank\">interviewed the seminal AIDS researcher Dr. Paul Volberding\u003c/a> about studies showing Truvada's effectiveness in preventing HIV transmission. He was tremendously excited about the possibilities of a prophylactic drug. \"This is the kind of effect we might expect from a very good vaccine,\" he said.\u003c/p>\n\u003cp>That enthusiasm has spread to both the Centers for Disease Control and the World Health Organization. CDC now says\u003ca href=\"https://www.washingtonpost.com/news/to-your-health/wp/2015/11/24/cdc-on-hiv-prevention-pill-how-to-tell-whether-you-should-be-taking-the-medication/\" target=\"_blank\"> about 1.2 million people \u003c/a>should at least consider PrEP, and four months ago the World Health Organization broadened its recommendation of who should take the medication, from men who have sex with men to \"all population groups at substantial risk of HIV infection.\"\u003c/p>\n\u003cp>Yet, what some have called a \"\u003ca href=\"https://www.washingtonpost.com/opinions/the-miracle-aids-drug-that-people-refust-to-take/2016/01/29/ba2b9460-b88a-11e5-b682-4bb4dd403c7d_story.html\" target=\"_blank\">miracle drug\u003c/a>\" that \u003ca href=\"http://www.nytimes.com/2014/07/17/upshot/is-truvada-the-pill-to-prevent-hiv-99-percent-effective-dont-be-so-sure.html?_r=0\" target=\"_blank\">works better\u003c/a> than \u003ca href=\"http://www.aidsmap.com/Consistent-condom-use-in-anal-sex-stops-70-of-HIV-infections-study-finds-but-intermittent-use-has-no-effect/page/2586976/\" target=\"_blank\">condoms\u003c/a> has been a bust in terms of adoption by the public.\u003c/p>\n\u003cp>\"\u003ca href=\"http://www.newyorker.com/tech/elements/why-is-no-one-on-the-first-treatment-to-prevent-h-i-v\" target=\"_blank\">Why Is No One On the First Treatment To Prevent H.I.V.?\u003c/a>\" The New Yorker asked in 2013.\u003c/p>\n\u003cp>\"Why have \u003ca href=\"http://www.natap.org/2013/ICAAC/ICAAC_04.htm\" target=\"_blank\">only 1,774 people\u003c/a>—half of whom are women—filled Truvada prescriptions over the last two years?\" \u003ca href=\"http://www.slate.com/blogs/outward/2014/01/06/truvada_prep_hiv_gay_men_should_take_pre_exposure_prophylaxis.html\" target=\"_blank\">Slate\u003c/a> asked in 2014.\u003c/p>\n\u003cp>\"Gilead’s Pill Can Stop HIV. So Why Does Almost Nobody Take It?\" \u003ca href=\"http://www.bloomberg.com/news/articles/2015-02-18/gilead-s-pill-can-stop-hiv-so-why-does-almost-nobody-take-it-\" target=\"_blank\">Bloomberg asked\u003c/a> in 2015.\u003c/p>\n\u003cp>\"\u003ca href=\"https://www.washingtonpost.com/opinions/the-miracle-aids-drug-that-people-refust-to-take/2016/01/29/ba2b9460-b88a-11e5-b682-4bb4dd403c7d_story.html\" target=\"_blank\">The miracle AIDS drug that people refuse to take,\u003c/a>\" an op-ed headline in The Washington Post read just two months ago.\u003c/p>\n\u003cp>\"Truvada’s been a financial success, bringing Gilead $1.79 billion in the U.S last year,\" Bloomberg reported in July. But that is due to its use by HIV-positive patients, not in those taking it for prevention. The report cited a \u003ca href=\"http://www.jiasociety.org/index.php/jias/article/view/19730/html\" target=\"_blank\">study\u003c/a> published in the November 2014 Journal of the International AIDS Society that found an unbelievably low 3,253 people, in the U.S., had used Truvada for PrEP between January 2012 and March 2014 -- only about 1,900 of those men.\u003c/p>\n\u003cp>The CDC says that figure is now about 21,000. According to an October 2015 \u003ca href=\"http://www.iapac.org/tasp_prep/presentations/TPSparis15-Panel-Grant.pdf\" target=\"_blank\">presentation\u003c/a> by Dr. Robert Grant, the protocol chair for a \u003ca href=\"https://www.google.com/search?q=iprex+study\" target=\"_blank\">multinational study on PrEP\u003c/a>, the number of U.S. users is about 22,000, and use of the drug \"has reached a tipping point.\"\u003c/p>\n\u003cp>Not according to Michael Weinstein, president of AIDS Healthcare Foundation, a global HIV/AIDS organization. Weinstein has been \u003ca href=\"https://www.frontiersmedia.com/frontiers-blog/2016/01/07/aids-healthcare-foundation-continues-to-wage-war-against-prep-reignites-party-drug-rhetoric/\" target=\"_blank\">outspoken\u003c/a> against mass adoption of Truvada, arguing it's a poor public health solution and drawing the wrath of some in the HIV health community. (The New York Times' Upshot \u003ca href=\"http://www.nytimes.com/2014/11/17/upshot/aids-group-wages-lonely-fight-against-pill-to-prevent-hiv.html\" target=\"_blank\">column\u003c/a> called him \"the most hated man in the AIDS business\" in 2014.)\u003c/p>\n\u003cp>Weinstein is well aware that the number of people taking Truvada is trivial.\u003c/p>\n\u003cp>\"The bottom line is we are now almost four years since the approval of this, and the last report from the CDC was that 21,000 people were taking it. Really, it's an insignificant number.\"\u003c/p>\n\u003cp>He said he thought the recent report about the Truvada failure out of Toronto \"will give some people pause\" about the drug. And he thinks the focus on Truvada is wrongheaded:\u003c/p>\n\u003cp>\"The messaging coming out is all about Truvada and PrEP, and not about condoms,\" he said. \"So we're seeing this huge s\u003ca href=\"http://www.cdc.gov/nchhstp/newsroom/2015/std-surveillance-report-press-release.html\" target=\"_blank\">pike in STDs\u003c/a> across the country. And I think it's because the CDC has really taken their foot off the gas and they're not saying anything about safer sex.\"\u003c/p>\n\u003cp>Dana Van Gorder is the executive director of Project Inform, which advocates for new HIV and hepatitis C treatments. He agrees that reduced condom use is a big factor in the rise of STDs. But he says PrEP use is so minimal, it can't be the culprit. Plus PrEP is better.\u003c/p>\n\u003cp>\"Condoms have been a great device, but on a statistical level, they're not as effective as PrEP can be in preventing infections, and the reality is just that not everyone is going to use them, for a variety of different reasons. So it feels unethical to us to not provide people with another option.\u003c/p>\n\u003cp>\"We can't just wish that people are going to use condoms more than they are.\"\u003c/p>\n\u003cp>Van Gorder said those who support Truvada were \"disappointed\" over the news it had failed for someone. But, he said, \"We'll continue to encourage PrEP use and stress it is highly effective but not necessarily 100 percent effective.\"\u003c/p>\n\u003cp>\u003cstrong>What, Exactly, is the Problem?\u003c/strong>\u003c/p>\n\u003cp>The reasons for PrEP's failure to catch on are manifold, Van Gorder said: Lack of effective education campaigns among \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/08/01/why-latinos-arent-taking-the-anti-hiv-pill-and-why-they-should-consider-it/\" target=\"_blank\">people of color\u003c/a> and injection drug users, for one; the need for follow-up appontments and testing, for another.\u003c/p>\n\u003cp>Also, he said, health care providers are not talking enough about PrEP to their patients. Some \"are actually hostile to it,\" he said.\u003c/p>\n\u003cp>Finally, Van Gorder said, PrEP is expensive. \"Covering its cost is not a small matter. While many insurers if not most are covering it, people often have high cost of sharing with deductibles and copays. Not everyone is in a position to [use] it.\"\u003c/p>\n\u003cp>But as Lisa Aliferis reported in KQED's \u003ca href=\"http://ww2.kqed.org/stateofhealth/2015/09/02/no-new-infections-in-hundreds-taking-pill-to-prevent-hiv/\" target=\"_blank\">State of Health blog\u003c/a> last September, there's another reason PrEP has failed to take off:\u003c/p>\n\u003cp>\"Despite the success of PrEP as a preventive, stigma remains,\" Aliferis wrote. \"People who take PrEP are sometimes viewed as promiscuous, [A PrEP patient] told me. “People say, ‘Why are you not just using condoms?’ … Sometimes people say, ‘You must be a slut.’\u003c/p>\n\u003cp>In fact, the term \"\u003ca href=\"http://www.advocate.com/health/2014/08/11/truvada-whore-stigma-endures-among-doctors-and-lgbts\" target=\"_blank\">Truvada whore\u003c/a>\" has often been used to describe PrEP users ... and not in a nice way, either. (The term has been\u003ca href=\"http://www.out.com/entertainment/popnography/2014/05/20/why-i-am-truvada-whore\" target=\"_blank\"> co-opted\u003c/a> by some Truvada fans.)\u003c/p>\n\u003cp>\u003cstrong>The Patient Speaks\u003c/strong>\u003c/p>\n\u003cp>Earlier this month, POZ, a magazine for people who are HIV-positive, published an \u003ca href=\"https://www.poz.com/article/meet-man-got-hiv-daily-prep\" target=\"_blank\">anonymous-yet-candid interview\u003c/a> with the Canadian PrEP user who still became infected.\u003c/p>\n\u003cp>When asked if PrEP altered his sexual behavior or attitudes, he answered:\u003c/p>\n\u003cp>\"Yes. I became more sexually liberated. It took away the fear. I mean, that’s really one of the reasons why people behave themselves [sexually]. It’s not because of morals or religion or society; it’s just the fear of getting sick—especially the fear of HIV. But once you’re on PrEP you’re more comfortable. You feel safer.\"\u003c/p>\n\u003cp>\u003cspan style=\"line-height: 1.5\">He said he's still a fan of the drug, despite its failure.\u003c/span>\u003c/p>\n\u003cp>\"PrEP’s a calculated risk,\" he said. \"It’s important for people to know that there is the possibility as opposed to the fantasy that there have been no recorded infections on PrEP. At least now there is one, so it makes it more real.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/134669/truvada-the-miracle-hiv-drug-few-people-take-suffers-another-setback","authors":["80"],"programs":["futureofyou_54"],"categories":["futureofyou_452","futureofyou_1","futureofyou_73"],"tags":["futureofyou_650","futureofyou_651","futureofyou_80","futureofyou_835","futureofyou_834"],"featImg":"futureofyou_134902","label":"futureofyou_54"},"futureofyou_64080":{"type":"posts","id":"futureofyou_64080","meta":{"index":"posts_1591205157","site":"futureofyou","id":"64080","score":null,"sort":[1448904037000]},"guestAuthors":[],"slug":"a-cure-for-aids-scientists-say-its-on-the-horizon","title":"A Cure for AIDS: Scientists Say It's 'On the Horizon'","publishDate":1448904037,"format":"image","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>\u003cspan style=\"font-size: 4.6875em;float: left;line-height: 0.733em;padding: 0.05em 0.1em 0 0;font-family: times, serif, georgia\">P\u003c/span>aul Volberding is a UCSF oncologist who treated San Francisco's first HIV patients in the early 1980s.\u003c/p>\n\u003cp>\"The patients were, in many cases, blind and demented and had cancer and had infections in their brains causing pressure and headaches,\" says Volberding. \"People now can’t imagine it, it was so bad.\"\u003c/p>\n\u003cp>Volberding says for years, HIV infection was a rapid death sentence. But in the 35 years since the epidemic began—thanks to sophisticated anti-retrovirals—it’s become a chronic illness that people can live with for decades.\u003c/p>\n\u003cp>Today, on the eve of World AIDS Day, UCSF is scheduled to announce that it's receiving a $20 million grant to find a cure for AIDS over the next five years. It's part of a $100 million effort by the \u003ca href=\"http://www.amfar.org/\" target=\"_blank\">American Foundation for AIDS Research\u003c/a> or amfAR, to fund the most promising research that could lead to curing AIDS.\u003c/p>\n\u003cp>Not long ago this might have sounded unbelievable.\u003c/p>\n\u003cfigure id=\"attachment_65878\" class=\"wp-caption alignleft\" style=\"max-width: 766px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/11/Paul-Volberding_1981-e1447277818233.jpg\">\u003cimg class=\"size-medium wp-image-65878\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/11/Paul-Volberding_1981-766x600.jpg\" alt=\"In 1981 Marcus Conant, MD (left) and Paul Volberding, MD (right) discuss Kaposi's Sarcoma, a disease that became one of the original AIDS-defining illnesses. \" width=\"766\" height=\"600\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">In 1981, Dr. Marcus Conant (left) and Dr. Paul Volberding (right) discuss Kaposi's Sarcoma, which became one of the original AIDS-defining illnesses. \u003ccite>(UCSF)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“I think it would have felt a lot like a moonshot, maybe five or six years ago,” Volberding says.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But today, Volberding's lab and others in San Francisco are working for that moonshot: to develop treatments over the next several years that can drive the viral load down low enough that the body's own immune system can control or eliminate it.\u003c/p>\n\u003cp>\"If it can be done anywhere, it can be done here,\" he says. \"It's a really exciting moment.\"\u003c/p>\n\u003cp>\u003cstrong>The Problem With Treatment\u003c/strong>\u003c/p>\n\u003cp>The U.S. Food and Drug Administration \u003ca href=\"http://hab.hrsa.gov/livinghistory/timeline/1987.htm\" target=\"_blank\">approved zidovudine or AZT\u003c/a> in 1987; it was the first antiretroviral medication to treat HIV.\u003c/p>\n\u003cp>By 1996, \u003ca href=\"http://www.cdc.gov/hiv/prevention/research/tap/\" target=\"_blank\">drug \"cocktails\" to treat HIV\u003c/a> became the standard of care for most patients. These highly active anti-retroviral therapies (HAART) helped manage the patient's viral load, maintained function of the immune system and prevented infections that could become fatal.\u003c/p>\n\u003cp>After HAART became widespread, the Centers for Disease Control and Prevention \u003ca href=\"http://www.cdc.gov/nchs/hus/chartbook.htm\" target=\"_blank\">reported a marked reduction in HIV-related deaths\u003c/a>.\u003c/p>\n\u003cp>But these medications have side effects.\u003c/p>\n\u003cp>\"Antiretrovirals are not a panacea,\" says amfAR CEO Kevin Robert Frost, who's based at the organization's headquarters in New York.\u003c/p>\n\u003cfigure id=\"attachment_72312\" class=\"wp-caption alignright\" style=\"max-width: 480px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/11/Kenneth-Cole_AIDS_ad.jpg\">\u003cimg class=\"wp-image-72312 size-medium\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/11/Kenneth-Cole_AIDS_ad-e1448386139756-480x600.jpg\" alt=\"A Kenneth Cole/amfAR ad from 1993 when 234,225 died of AIDS.\" width=\"480\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/11/Kenneth-Cole_AIDS_ad-e1448386139756-480x600.jpg 480w, https://ww2.kqed.org/app/uploads/sites/13/2015/11/Kenneth-Cole_AIDS_ad-e1448386139756-400x500.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/11/Kenneth-Cole_AIDS_ad-e1448386139756.jpg 574w\" sizes=\"(max-width: 480px) 100vw, 480px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A Kenneth Cole/amfAR ad from 1993 when 234,225 people died of AIDS. \u003ccite>(amfAR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Frost says the drugs have side effects that include chronic inflammation and a range of infections that attack the weakened immune system.\u003c/p>\n\u003cp>That's why amfAR is spending $100 million to find a cure for the \u003ca href=\"http://www.amfar.org/worldwide-aids-stats/\" target=\"_blank\">nearly 37 million people living with HIV\u003c/a> around the world.\u003c/p>\n\u003cp>\"The only real way out of an epidemic like this is through a cure and a vaccine,\" says Frost. \"Because we’re gonna have to cure the people who have it now and we’re gonna have to vaccinate those to prevent them from getting it in the future.\"\u003c/p>\n\u003cp>\u003cstrong>'Shock and Kill' the Virus\u003c/strong>\u003c/p>\n\u003cp>Like many HIV patients, TJ Lee is active and pain-free.\u003c/p>\n\u003cp>\"Once you get on meds and take care of yourself, you can live a very normal life,\" says Lee, who has been HIV-positive for 16 years.\u003c/p>\n\u003cp>The San Francisco resident takes just one pill a day to manage his HIV. As a program manager at the San Francisco AIDS Foundation he works with newly diagnosed people who don't know HIV is no longer a death sentence.\u003c/p>\n\u003cp>\"I had somebody call me about a month ago,\" Lee says. \"He recently found out he had HIV and he thought he was going to die soon.\"\u003c/p>\n\u003cp>For people who have access to treatment, that's not really a concern anymore.\u003c/p>\n\u003cp>However, even people who are free of symptoms can have HIV lying dormant in their body’s T cells for years. The inactive virus could one day become active and reproduce.\u003c/p>\n\u003cp>Eliminating that latent virus is the focus of UCSF's research. With the $20 million amfAR grant, Volberding wants to target these viral cells with a method he calls shock and kill.\u003c/p>\n\u003cp>\u003cem>The Shock and Kill Method of Eliminating the Virus\u003c/em>\u003cbr>\n\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/11/Shock-and-kill_edited1.jpg\">\u003cimg class=\"size-medium wp-image-66472 aligncenter\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/11/Shock-and-kill_edited1-800x230.jpg\" alt=\"Shock and kill_edited\" width=\"800\" height=\"230\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/11/Shock-and-kill_edited1-800x230.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/11/Shock-and-kill_edited1-400x115.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/11/Shock-and-kill_edited1-1180x339.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/11/Shock-and-kill_edited1-960x276.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/11/Shock-and-kill_edited1.jpg 1592w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003c/p>\n\u003cp>\"If the virus is dormant, we first need to wake up that cell to start producing the virus, that’s the shock part of it,\" Volberding says. \"And then, once the virus has been activated we want to do something to help the body kill off those cells, to get rid of the virus.\"\u003c/p>\n\u003cp>Researchers have to wake up the virus because when it’s dormant, the infected cell is invisible to the immune system. By shocking it out of latency, scientists can kill the infected cells, and kill the virus as it reproduces.\u003c/p>\n\u003cp>\u003cstrong>Listen to the Story:\u003c/strong>\u003cbr>\nhttp://www.kqed.org/.stream/anon/radio//2015/11/AIDSCure.mp3\u003c/p>\n\u003cp>This method could be \u003cem>an \u003c/em>answer, Frost says, not \u003cem>the\u003c/em> answer. Researchers are working on multiple ways of reducing the body's viral load, including rapid early treatment to abort the infection and gene therapy to engineer cells to make them resistant to infection. Plus, public health efforts aimed at prevention and treatment will continue to be important, especially in places like sub-Saharan Africa, where 28.5 million people are infected with HIV.\u003c/p>\n\u003cp>\"I don’t think we’re gonna wake up one day and see a headline in the newspaper that says 'Cure for AIDS Found,'” Frost says. \"It’s not that kind of a disease, it’s much more complicated than that.\"\u003c/p>\n\u003caside class=\"pullquote alignleft\">‘People who say a cure for AIDS is impossible simply don’t understand the science.’\u003ccite> Kevin Robert Frost,\u003cbr>\namfAR CEO\u003c/cite>\u003c/aside>\n\u003cp>Because HIV mutates so quickly, he adds, a cure is likely to come in stages—sort of like a cancer model where a patient goes into remission.\u003c/p>\n\u003cp>Remission would mean a point where the patient doesn’t need treatment, can’t infect anyone, and doesn't have chronic illnesses.\u003c/p>\n\u003cp>\"We’re likely to start out curing some of the people some of the time, then more of the people more of the time,\" he says, \"and hopefully get to a place where we cure most of the people most of the time, and everybody who needs it has access to it.\"\u003c/p>\n\u003cp>Frost says eliminating the virus will take not one, but a series of scientific breakthroughs, as researchers work on all fronts from latency to gene editing and gene therapy.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"There are those who said space travel would never happen,\" says Frost. \"People who say a cure for AIDS is impossible simply don’t understand the science. We’re going to find a cure for AIDS; I can tell you that without the slightest hesitation or doubt in my mind.\"\u003c/p>\n\n","blocks":[],"excerpt":"Thirty years since the AIDS epidemic broke out, we're closer than ever to finding a cure. And Bay Area scientists are getting $20 million to help find it.\r\n","status":"publish","parent":0,"modified":1456901661,"stats":{"hasAudio":true,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":38,"wordCount":1141},"headData":{"title":"A Cure for AIDS: Scientists Say It's 'On the Horizon' | KQED","description":"Thirty years since the AIDS epidemic broke out, we're closer than ever to finding a cure. And Bay Area scientists are getting $20 million to help find it.\r\n","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":""},"disqusIdentifier":"64080 http://ww2.kqed.org/futureofyou/?p=64080","disqusUrl":"https://ww2.kqed.org/futureofyou/2015/11/30/a-cure-for-aids-scientists-say-its-on-the-horizon/","disqusTitle":"A Cure for AIDS: Scientists Say It's 'On the Horizon'","path":"/futureofyou/64080/a-cure-for-aids-scientists-say-its-on-the-horizon","audioUrl":"http://www.kqed.org/.stream/anon/radio//2015/11/AIDSCure.mp3","audioDuration":null,"audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cspan style=\"font-size: 4.6875em;float: left;line-height: 0.733em;padding: 0.05em 0.1em 0 0;font-family: times, serif, georgia\">P\u003c/span>aul Volberding is a UCSF oncologist who treated San Francisco's first HIV patients in the early 1980s.\u003c/p>\n\u003cp>\"The patients were, in many cases, blind and demented and had cancer and had infections in their brains causing pressure and headaches,\" says Volberding. \"People now can’t imagine it, it was so bad.\"\u003c/p>\n\u003cp>Volberding says for years, HIV infection was a rapid death sentence. But in the 35 years since the epidemic began—thanks to sophisticated anti-retrovirals—it’s become a chronic illness that people can live with for decades.\u003c/p>\n\u003cp>Today, on the eve of World AIDS Day, UCSF is scheduled to announce that it's receiving a $20 million grant to find a cure for AIDS over the next five years. It's part of a $100 million effort by the \u003ca href=\"http://www.amfar.org/\" target=\"_blank\">American Foundation for AIDS Research\u003c/a> or amfAR, to fund the most promising research that could lead to curing AIDS.\u003c/p>\n\u003cp>Not long ago this might have sounded unbelievable.\u003c/p>\n\u003cfigure id=\"attachment_65878\" class=\"wp-caption alignleft\" style=\"max-width: 766px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/11/Paul-Volberding_1981-e1447277818233.jpg\">\u003cimg class=\"size-medium wp-image-65878\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/11/Paul-Volberding_1981-766x600.jpg\" alt=\"In 1981 Marcus Conant, MD (left) and Paul Volberding, MD (right) discuss Kaposi's Sarcoma, a disease that became one of the original AIDS-defining illnesses. \" width=\"766\" height=\"600\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">In 1981, Dr. Marcus Conant (left) and Dr. Paul Volberding (right) discuss Kaposi's Sarcoma, which became one of the original AIDS-defining illnesses. \u003ccite>(UCSF)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>“I think it would have felt a lot like a moonshot, maybe five or six years ago,” Volberding says.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But today, Volberding's lab and others in San Francisco are working for that moonshot: to develop treatments over the next several years that can drive the viral load down low enough that the body's own immune system can control or eliminate it.\u003c/p>\n\u003cp>\"If it can be done anywhere, it can be done here,\" he says. \"It's a really exciting moment.\"\u003c/p>\n\u003cp>\u003cstrong>The Problem With Treatment\u003c/strong>\u003c/p>\n\u003cp>The U.S. Food and Drug Administration \u003ca href=\"http://hab.hrsa.gov/livinghistory/timeline/1987.htm\" target=\"_blank\">approved zidovudine or AZT\u003c/a> in 1987; it was the first antiretroviral medication to treat HIV.\u003c/p>\n\u003cp>By 1996, \u003ca href=\"http://www.cdc.gov/hiv/prevention/research/tap/\" target=\"_blank\">drug \"cocktails\" to treat HIV\u003c/a> became the standard of care for most patients. These highly active anti-retroviral therapies (HAART) helped manage the patient's viral load, maintained function of the immune system and prevented infections that could become fatal.\u003c/p>\n\u003cp>After HAART became widespread, the Centers for Disease Control and Prevention \u003ca href=\"http://www.cdc.gov/nchs/hus/chartbook.htm\" target=\"_blank\">reported a marked reduction in HIV-related deaths\u003c/a>.\u003c/p>\n\u003cp>But these medications have side effects.\u003c/p>\n\u003cp>\"Antiretrovirals are not a panacea,\" says amfAR CEO Kevin Robert Frost, who's based at the organization's headquarters in New York.\u003c/p>\n\u003cfigure id=\"attachment_72312\" class=\"wp-caption alignright\" style=\"max-width: 480px\">\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/11/Kenneth-Cole_AIDS_ad.jpg\">\u003cimg class=\"wp-image-72312 size-medium\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/11/Kenneth-Cole_AIDS_ad-e1448386139756-480x600.jpg\" alt=\"A Kenneth Cole/amfAR ad from 1993 when 234,225 died of AIDS.\" width=\"480\" height=\"600\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/11/Kenneth-Cole_AIDS_ad-e1448386139756-480x600.jpg 480w, https://ww2.kqed.org/app/uploads/sites/13/2015/11/Kenneth-Cole_AIDS_ad-e1448386139756-400x500.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/11/Kenneth-Cole_AIDS_ad-e1448386139756.jpg 574w\" sizes=\"(max-width: 480px) 100vw, 480px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A Kenneth Cole/amfAR ad from 1993 when 234,225 people died of AIDS. \u003ccite>(amfAR)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Frost says the drugs have side effects that include chronic inflammation and a range of infections that attack the weakened immune system.\u003c/p>\n\u003cp>That's why amfAR is spending $100 million to find a cure for the \u003ca href=\"http://www.amfar.org/worldwide-aids-stats/\" target=\"_blank\">nearly 37 million people living with HIV\u003c/a> around the world.\u003c/p>\n\u003cp>\"The only real way out of an epidemic like this is through a cure and a vaccine,\" says Frost. \"Because we’re gonna have to cure the people who have it now and we’re gonna have to vaccinate those to prevent them from getting it in the future.\"\u003c/p>\n\u003cp>\u003cstrong>'Shock and Kill' the Virus\u003c/strong>\u003c/p>\n\u003cp>Like many HIV patients, TJ Lee is active and pain-free.\u003c/p>\n\u003cp>\"Once you get on meds and take care of yourself, you can live a very normal life,\" says Lee, who has been HIV-positive for 16 years.\u003c/p>\n\u003cp>The San Francisco resident takes just one pill a day to manage his HIV. As a program manager at the San Francisco AIDS Foundation he works with newly diagnosed people who don't know HIV is no longer a death sentence.\u003c/p>\n\u003cp>\"I had somebody call me about a month ago,\" Lee says. \"He recently found out he had HIV and he thought he was going to die soon.\"\u003c/p>\n\u003cp>For people who have access to treatment, that's not really a concern anymore.\u003c/p>\n\u003cp>However, even people who are free of symptoms can have HIV lying dormant in their body’s T cells for years. The inactive virus could one day become active and reproduce.\u003c/p>\n\u003cp>Eliminating that latent virus is the focus of UCSF's research. With the $20 million amfAR grant, Volberding wants to target these viral cells with a method he calls shock and kill.\u003c/p>\n\u003cp>\u003cem>The Shock and Kill Method of Eliminating the Virus\u003c/em>\u003cbr>\n\u003ca href=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/11/Shock-and-kill_edited1.jpg\">\u003cimg class=\"size-medium wp-image-66472 aligncenter\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/11/Shock-and-kill_edited1-800x230.jpg\" alt=\"Shock and kill_edited\" width=\"800\" height=\"230\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/11/Shock-and-kill_edited1-800x230.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2015/11/Shock-and-kill_edited1-400x115.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/11/Shock-and-kill_edited1-1180x339.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/11/Shock-and-kill_edited1-960x276.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/11/Shock-and-kill_edited1.jpg 1592w\" sizes=\"(max-width: 800px) 100vw, 800px\">\u003c/a>\u003c/p>\n\u003cp>\"If the virus is dormant, we first need to wake up that cell to start producing the virus, that’s the shock part of it,\" Volberding says. \"And then, once the virus has been activated we want to do something to help the body kill off those cells, to get rid of the virus.\"\u003c/p>\n\u003cp>Researchers have to wake up the virus because when it’s dormant, the infected cell is invisible to the immune system. By shocking it out of latency, scientists can kill the infected cells, and kill the virus as it reproduces.\u003c/p>\n\u003cp>\u003cstrong>Listen to the Story:\u003c/strong>\u003cbr>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"audioLink","attributes":{"named":{"src":"http://www.kqed.org/.stream/anon/radio//2015/11/AIDSCure.mp3"},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>This method could be \u003cem>an \u003c/em>answer, Frost says, not \u003cem>the\u003c/em> answer. Researchers are working on multiple ways of reducing the body's viral load, including rapid early treatment to abort the infection and gene therapy to engineer cells to make them resistant to infection. Plus, public health efforts aimed at prevention and treatment will continue to be important, especially in places like sub-Saharan Africa, where 28.5 million people are infected with HIV.\u003c/p>\n\u003cp>\"I don’t think we’re gonna wake up one day and see a headline in the newspaper that says 'Cure for AIDS Found,'” Frost says. \"It’s not that kind of a disease, it’s much more complicated than that.\"\u003c/p>\n\u003caside class=\"pullquote alignleft\">‘People who say a cure for AIDS is impossible simply don’t understand the science.’\u003ccite> Kevin Robert Frost,\u003cbr>\namfAR CEO\u003c/cite>\u003c/aside>\n\u003cp>Because HIV mutates so quickly, he adds, a cure is likely to come in stages—sort of like a cancer model where a patient goes into remission.\u003c/p>\n\u003cp>Remission would mean a point where the patient doesn’t need treatment, can’t infect anyone, and doesn't have chronic illnesses.\u003c/p>\n\u003cp>\"We’re likely to start out curing some of the people some of the time, then more of the people more of the time,\" he says, \"and hopefully get to a place where we cure most of the people most of the time, and everybody who needs it has access to it.\"\u003c/p>\n\u003cp>Frost says eliminating the virus will take not one, but a series of scientific breakthroughs, as researchers work on all fronts from latency to gene editing and gene therapy.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"There are those who said space travel would never happen,\" says Frost. \"People who say a cure for AIDS is impossible simply don’t understand the science. We’re going to find a cure for AIDS; I can tell you that without the slightest hesitation or doubt in my mind.\"\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/64080/a-cure-for-aids-scientists-say-its-on-the-horizon","authors":["5432"],"categories":["futureofyou_1","futureofyou_73"],"tags":["futureofyou_650","futureofyou_669","futureofyou_80","futureofyou_113"],"featImg":"futureofyou_66445","label":"futureofyou"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2023/08/possible-5gxfizEbKOJ-pbF5ASgxrs_.1400x1400.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. 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But is this once sleepy suburb ready for them?","imageSrc":"https://ww2.kqed.org/news/wp-content/uploads/sites/10/powerpress/1440_0018_AmericanSuburb_iTunesTile_01.jpg","officialWebsiteLink":"/news/series/american-suburb-podcast","meta":{"site":"news","source":"kqed","order":"13"},"link":"/news/series/american-suburb-podcast/","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?mt=2&id=1287748328","tuneIn":"https://tunein.com/radio/American-Suburb-p1086805/","rss":"https://ww2.kqed.org/news/series/american-suburb-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkMzMDExODgxNjA5"}},"baycurious":{"id":"baycurious","title":"Bay Curious","tagline":"Exploring the Bay Area, one question at a time","info":"KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.","imageSrc":"https://ww2.kqed.org/news/wp-content/uploads/sites/10/powerpress/1440_0017_BayCurious_iTunesTile_01.jpg","imageAlt":"\"KQED Bay Curious","officialWebsiteLink":"/news/series/baycurious","meta":{"site":"news","source":"kqed","order":"4"},"link":"/podcasts/baycurious","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/bay-curious/id1172473406","npr":"https://www.npr.org/podcasts/500557090/bay-curious","rss":"https://ww2.kqed.org/news/category/bay-curious-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvbmV3cy9jYXRlZ29yeS9iYXktY3VyaW91cy1wb2RjYXN0L2ZlZWQvcG9kY2FzdA","stitcher":"https://www.stitcher.com/podcast/kqed/bay-curious","spotify":"https://open.spotify.com/show/6O76IdmhixfijmhTZLIJ8k"}},"bbc-world-service":{"id":"bbc-world-service","title":"BBC World Service","info":"The day's top stories from BBC News compiled twice daily in the week, once at weekends.","airtime":"MON-FRI 9pm-10pm, TUE-FRI 1am-2am","imageSrc":"https://ww2.kqed.org/app/uploads/2021/10/BBC_1400.jpg","officialWebsiteLink":"https://www.bbc.co.uk/sounds/play/live:bbc_world_service","meta":{"site":"news","source":"BBC World Service"},"link":"/radio/program/bbc-world-service","subscribe":{"apple":"https://itunes.apple.com/us/podcast/global-news-podcast/id135067274?mt=2","tuneIn":"https://tunein.com/radio/BBC-World-Service-p455581/","rss":"https://podcasts.files.bbci.co.uk/p02nq0gn.rss"}},"code-switch-life-kit":{"id":"code-switch-life-kit","title":"Code Switch / Life Kit","info":"\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2021/12/CodeSwitchLifeKit_StationGraphics_300x300EmailGraphic.png","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. 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