What will it take to eradicate HIV?

In 1980sThose diagnosed with HIV faced a dire prognosis: there was no cure, no treatable condition and very little hope. 40 Years LaterMost people with HIV can live longer, healthier lives by taking their HIV treatment as prescribed.

This progress is remarkable. But looking at the HIV epidemic from 10,000 feet can be misleading, like looking out an airplane window: Researchers and clinicians can sometimes feel like very little progress has actually been made. Their destination — The end of the HIV epidemic.

“Some days, the complexity is overwhelming,” Jared Baeten, vice president of HIV clinical development at Gilead Sciences, said at STAT's Breakthrough Summit West in San Francisco about efforts to end the HIV epidemic. “But then you meet with someone who's solved a small problem within that larger complexity, and you think, 'Okay, all of this is did it “Come with me.”

That day is so close we can hardly wait. [United Nations] “We have a goal to end the HIV pandemic by the end of this decade,” Baeten said.

What will it take to complete that final step? Let's consider where we are now, where we're going next, and what we can do to improve the lives of people affected by HIV in the meantime.

What will the HIV epidemic look like in 2024?

of Positive change The progress that has been made in terms of what it is like to live with HIV is the culmination of years of global scientific research. “I remember well the beginning of the epidemic in the '80s and how devastating it was,” Baeten said. “I've had the privilege of seeing the progress that's been made over the years, and many of those advances have been spearheaded by Gilead, which is a company that has been working to improve the lives of millions of people worldwide.” Helped transform HIV It goes from a virus that causes deadly disease to a chronic, treatable illness.”

“Developed by Gilead “It's the first single-pill therapy to treat HIV and the first pre-exposure prophylaxis (PrEP) drug to prevent HIV infection. And now we're committed to research that will hopefully one day lead to a cure.”

What are some of the challenges that remain?

Worldwide estimate 1.3 million More than 3,000 people will be diagnosed with HIV in 2022. In the United States, one-third of people with HIV I have not received Based on 2018 data, HIV care was required.

“But it's not because their virus is untreatable,” Baeten says, “it's because the medicines available may not work for them at all. A lot of this is driven by the stigma and discrimination that's been with them since the beginning of HIV. Fear, stigma and discrimination are often Chasing people away “There's an issue with people not being able to get the care they need, so we're really focused on meeting people where they are.”

Bettina Bauer, vice president of U.S. HIV treatment and prevention at Gilead Sciences, agreed, speaking at Summit West in the Multimedia Lounge at STAT Brand Studios. “We can't do this with medicine alone,” Bauer said. “I've seen firsthand how communities are still being affected by this epidemic, and it's disproportionately impacting some communities that experience deep health disparities and have higher barriers to accessing health care. This is especially true for Black Community, Latino Community, womanand Transgender CommunityThese are just a few examples. This highlights the need for person-centred care, particularly one that recognises the interconnectedness between these groups.”

What can be done to address these challenges?

Education is one of the most important steps. Research in 2020 It found that 40% of people surveyed were unaware that HIV is a treatable disease and some communities face barriers to accessing and understanding treatment options.

These options include not only treatment but also preventative measures such as using condoms during sex and PrEP, which, if taken as prescribed before HIV infection, is highly effective in reducing the chance of sexually transmitting HIV by about 99%, according to the U.S. Department of Health. Centers for Disease Control and Prevention.

Providing tailored educational resources for different communities, eliminating HIV stigma and normalizing sexual health, and encouraging knowledge sharing wherever possible are all important foundational steps in reducing the impact of HIV.

What is the emerging area of ​​focus in HIV treatment and how is Gilead working to address this from a clinical perspective?

“A challenge we see recurring is the emergence of HIV drug resistance,” Baeten said.

HIV drug resistance Treatment can fail if the virus mutates and no longer responds to previously effective drugs. Treatment-resistant strains The HIV virus can be transmitted to others, potentially undermining broader efforts to end the epidemic. “There's no virus as sneaky as HIV,” Baeten says. “It can slip through a lot of things you put in front of it.”

Drug resistance in HIV is irreversible, but It is manageableThe risk of resistance development is also reduced, which is an important goal in HIV treatment. Collaboration with medical teams Identifying potential HIV resistance mutations, considering regimen resistance barriers when selecting HIV treatment, and encouraging HIV-infected individuals to prioritize treatment adherence are all important.

“When we create new drugs or use current drugs, we are mindful that they have to be able to withstand the virus developing resistance,” Baeten said.

What is being done to improve the lives of people living with HIV?

Knowing that each person with HIV has unique needs and preferences, research is focused on evolving options that address each individual's needs and preferences. “Right now we're putting a lot of effort into our long-term strategy,” Baeten says. “We want to give people more options that might help them. We also know that we can't end the HIV epidemic alone. We're working hard to build partnerships with communities, advocates, scientists, and people affected by HIV at the local and national levels to address barriers and ensure people get the care they deserve.”

After all, Bauer said, “I mean; [HIV] “In treatment, we need to have options that work for a very broad range of people. And in prevention, frankly, we want access to more people who can benefit. We're committed to providing people with person-centered innovations that help meet their individual needs.”

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