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Scientists on path to HIV cure

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It's been thirty years since HIV-AIDS made world headlines but there's still no cure for the disease.

The most notable advance against HIV-AIDS has been a combination of anti-retroviral drugs which have kept full-blown AIDS from totally destroying the body's immune system.

Now, scientists are again talking about finding a cure or at least paving the way towards one.

BENKIRANE: We have a very powerful drugs against HIV and these drugs really do a great job in terms of suppressing the virus in the blood. We have about 15 years experience with these drugs, and we know they will not cure HIV. So I think one of the challenges is to try to understand why and try to develop new drugs that will make us able to cure the virus. We're talking about two types of cure: either the complete eradication of the virus from the body; or, just functional cure. What we mean about functional cure is actually to be able to stop the therapy without having viral rebound, so people can live without treatment.

Question: And central to the search for a cure, I understand is this modulator protein. Can you tell us about this modulator protein and how it works?

BENKIRANE: This is a different issue, this is more like related to the immune responses. So this protein that we actually identified is a protein that protects dendritic cells from being infected by HIV. So what are the dendritic cells? Those are the cells that normally initiate innate immunity and also orchestrate the adaptive immunities, specific immunity against a virus or an invader. The problem with this is that HIV escapes and is not sensed by these cells, so when these cells capture the virus, they do not do their job. What they do, however, because they capture the virus, they express the receptor and everything required for the binding and they take the virus up to the lymph nodes, where the virus likes to replicate the most, which are the activated CD45 T cells. Because these cells are the first cells that contact the virus during transmission,  what is aimed is  to actually make these cells able to sense the virus and one way to do that is to make them permissive to the virus. To achieve this, we have to identify the restrictions so that they operate in these cells and that is the SAMHD1 that we identified. The hope here actually is to see if we act on this protein, if we make these dendritic cells permissive to the virus, that will initiate innate immunity and they will also orchestrate a good and very early adaptive immunity against HIV which may lea d to a better control of the virus.

Question: Dr Benkirane, it's World AIDS Day. What is your assessment of the medical and scientific work that's been going on so far towards finding a cure? Thirty years on, is there global collaboration, are we moving forward?

BENKIRANE: Yes, there is global collaboration. I think there have been really great progress in HIV AIDS in terms of treatment, vaccine and prevention. I think the most important thing that we recently learned is that treatment is prevention, because people who are treated, people who are under suppressive drugs barely transmit the virus. I think this is some  really important information.

Now the vaccine field is moving very nicely, I think because of the recent Thai trial. I think it's the first time we have some hope. It's not going to beat that, but I think it's a good starting point. The other challenge that I think we're going to have to face is the cure, trying to develop a way to help the anti-viral therapy that we currently make, either to be able to eradicate the virus or at least have a functional cure.

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