In the developed nations, people who have HIV, the AIDS virus, live daily with antiretrovirals: a treatment which at the time changed the course of the disease (the population of rich countries stopped dying of AIDS) because it helps the immune system to control the virus. However, antiretrovirals have Long term effects. One of the high hopes currently in the field of HIV/AIDS is the therapeutic vaccine, it’s a replacement immunotherapy of these drugs and better quality. There are several in progress and the Fundació Lluita against infections (formerly called Lluita Contra la Sida) is developing its own.
“With a therapeutic vaccine, we are looking for an intervention in the immune system that controls the virus without the need to take medication, Explain Pepe Molto, attending physician and researcher German Hospital Trias i Pujol (Can Ruti, in Badalona) and the Fundació Lluita Contra les Infeccions, within the framework of World AIDS Day, celebrated today. ‘Nature Medicine’ recently published the results of the clinical trial (in phase two and in which 45 people participated) of HTI therapeutic vaccine of this entity, which confirmed that the 40% of attendees who have received the vaccine control the virus better thanks to it. In Catalonia there are some 33,365 people suffer from the infection and the incidence is six times lower today than in 2010.
The vaccine, insists Moltó, is a “substitute” for antiretrovirals: it pursues, like them, a “undetectable viral load”. That is to say, does not remove the virus (like these drugs neither), but it manages to control it by the immune system itself. “We are living a golden age of antiretrovirals but they do not kill the virus, so patients should take them for life. In addition to having the possibility Side effects for the patient, they represent a Economic load for the system”, explains the researcher.
Moltó stresses that the therapeutic vaccine is “very important” and that researchers are getting “closer” to it. “We find that vaccines they are safe Yes They don’t have any serious side effects,” stands. It is still unclear how often this injection would be given. “We must first see the short-term effectiveness. Then, studies would be done to see how long it lasts and when to apply reinforcements”, adds this researcher.
The Prepa, the other revolution
Moltó assures that the investigation “is on the way to a functional cure” of HIV/AIDS. And he points out that in this regard, the pre-exposure prophylaxis (Prep, the pill that, taken before risky practices, prevents contagion and that Spain has included in its portfolio of services since 2019) “changed everything” Well he succeeded lower infection rates. In Spain, 9,000 people follow the Prep, of which 5,000 live in Catalonia. And among them, 2,000 are BCN preparation point, Center part of BCN Checkpoint, specialized in the rapid diagnosis of HIV infections.
“Preparation is for orally. But we already have data Preparation injected every two months, and which are recording even better results”, underlines Moltó. For him, the key lies in continue to diagnose (“there are people who have the infection and don’t know it”) and in “provide a test”.
No maternal transmission in Spain
According to the latest epidemiological data on HIV from the Spanish Ministry of Health, in 2020 there were no cases of vertical transmission, that is, no child contracted the virus during pregnancy, childbirth or breastfeeding. These figures were achieved thanks to the antiretroviral therapy, which allows the virus to remain undetectable in the mother’s blood and cannot be transmitted, according to the AIDS Research Institute IrsiCaixa, Center jointly promoted by Fundación la Caixa and the Ministry of Health of Catalonia.
IrsiCaixa participates in studies, conducted by the University of Oxford, which characterize the infection in babies. The results obtained to date show that the start of treatment immediately after delivery limits the persistence of the viral reservoir and that there are differences according to the sex of the baby.
81% of those infected are men
According to the Ministry of Health, last year in Catalonia returned to decrease in HIV infections as data from the Center for Epidemiological Studies on STIs and AIDS of Catalonia (Ceeiscat) show, In 2021, 344 new diagnoses were registered, 20% less compared to 2020. Overall, it is estimated that 33,365 people are living with HIV in Catalonia, which represents an incidence rate of 4.4 cases per 100,000 inhabitants compared to 11 cases per 100,000 inhabitants in 2010.
the 81% of infected people are Men’s and the median age of people living with HIV is 37 years. The main route of transmission was sexual, with 72% of new diagnoses occurring in men who have sex with men and 14% in heterosexual men and women.
Around the world, the HIV epidemic is affecting 38.4 million people. In 2021, it caused 650,000 deaths and 1.5 million new infections. Overall, it is currently estimated that 28.7 million people access the antiretroviral therapy. New innovations, such as therapeutic vaccines, could lead to a strategic shift in HIV care.